Hermida-Rodriguez C, Cantero Perona J, Garcia-Valriberas R, Pajares Garcia J M, Mate-Jimenez J
Servicio de Aparato Digestivo, Hospital Universitario de la Princesa, Universidad Autonoma de Madrid, Spain.
Hepatogastroenterology. 1999 Jul-Aug;46(28):2265-8.
BACKGROUND/AIMS: To determin whether cyclosporine is effective in inducing remission in patients with severe active inflammatory bowel disease, refractory to steroids.
Twenty-three patients with severe and steroid-refractory inflammatory bowel disease (15 ulcerative colitis and 8 Crohn's disease) were included. The Mayo Clinic Score and the CDAI were used to evaluate activity. Cyclosporine (4 mg/kg/day) was administered for a maximum of ten and a minimum of 7 days.
Ten of the 15 ulcerative colitis patients achieved remission with a mean response lag time to onset improvement of 8 days. Seven of these patients remained stable with mesalazine 4 months after cyclosporine treatment. Two patients relapsed and underwent colectomy on the 50th and 200th day after treatment. Five patients presented no response and required urgent colectomy. Six of the 8 Crohn's disease patients achieved remission with a mean response lag time to onset improvement of 7 days. The 6 patients remained stable with mesalazine four months after cyclosporine treatment. The other 2 developed reversible renal failure and had to be released from the study.
Intravenous high dose cyclosporine is effective and can be used as a rapid onset treatment for acute steroid refractory IBD.
背景/目的：确定环孢素对重症活动性炎症性肠病且对类固醇难治的患者诱导缓解是否有效。
纳入23例重症且对类固醇难治的炎症性肠病患者（15例溃疡性结肠炎和8例克罗恩病）。采用梅奥诊所评分和CDAI评估疾病活动度。给予环孢素（4毫克/千克/天），最长给药10天，最短7天。
15例溃疡性结肠炎患者中有10例实现缓解，从开始改善到缓解的平均反应延迟时间为8天。其中7例患者在环孢素治疗4个月后使用美沙拉嗪病情保持稳定。2例患者复发，并在治疗后第50天和第200天接受了结肠切除术。5例患者无反应，需要紧急进行结肠切除术。8例克罗恩病患者中有6例实现缓解，从开始改善到缓解的平均反应延迟时间为7天。这6例患者在环孢素治疗4个月后使用美沙拉嗪病情保持稳定。另外2例出现可逆性肾衰竭，不得不退出研究。
静脉注射高剂量环孢素有效，可作为急性类固醇难治性炎症性肠病的快速起效治疗方法。
