Kosaka T, Sawada K, Ohnishi K, Egashira A, Yamamura M, Tanida N, Satomi M, Shimoyama T
Department of Internal Medicine IV, Hyogo College of Medicine, Nishinomiya.
Intern Med. 1999 Feb;38(2):102-11. doi: 10.2169/internalmedicine.38.102.
Eighteen patients with active Crohn's disease were treated with one leukocytapheresis session per week for a five-week intensive therapy, decreasing to one leukocytapheresis session per month for five sessions of initial maintenance therapy. Nutritional indices, inflammatory reactions, flow cytometry profiles, and cytokine production were also assessed before and after the intensive and initial maintenance therapy. Nine of the patients (50%) attained remission at the end of the intensive therapy. The nine non-remission patients had exhibited longer periods of suffering and more severely affected sites prior to the therapy. In 14 of 18 patients (77.8%), the nutritional indices, Internal Organization of Inflammatory Bowel Disease (IOIBD) score and Crohn's Disease Activity Index (CDAI) improved from the pretherapy levels, but only the remission group (50%) showed improvement in C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). The remission group showed significantly higher pretherapy CD4+ CD45+ cell ratios and interleukin-2 (IL-2) production than the non-remission group, and significantly lower activated cells.
18例活动性克罗恩病患者接受了为期5周的强化治疗，每周进行1次白细胞去除术，之后减至每月1次白细胞去除术，进行5次初始维持治疗。在强化治疗和初始维持治疗前后，还评估了营养指标、炎症反应、流式细胞仪分析图谱和细胞因子产生情况。9例患者（50%）在强化治疗结束时达到缓解。9例未缓解患者在治疗前患病时间更长，病变部位受影响更严重。18例患者中有14例（77.8%）的营养指标、炎症性肠病内部组织（IOIBD）评分和克罗恩病活动指数（CDAI）较治疗前有所改善，但只有缓解组（50%）的C反应蛋白（CRP）和红细胞沉降率（ESR）有所改善。缓解组治疗前的CD4+ CD45+细胞比率和白细胞介素-2（IL-2）产生显著高于未缓解组，活化细胞显著更低。
