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环丙沙星与安慰剂治疗小肠结肠炎耶尔森菌引发的反应性关节炎的对比研究

Ciprofloxacin v placebo for treatment of Yersinia enterocolitica triggered reactive arthritis.

作者信息

Hoogkamp-Korstanje J A, Moesker H, Bruyn G A

机构信息

Department of Medical Microbiology, University Hospital Nijmegen, Geert Grooteplein 24, 6500 HB Nijmegen, The Netherlands.

出版信息

Ann Rheum Dis. 2000 Nov;59(11):914-7. doi: 10.1136/ard.59.11.914.

Abstract

Patients with yersinia triggered reactive arthritis were double blind randomly allocated to receive treatment with ciprofloxacin 500 mg twice daily orally or placebo during three months. The diagnosis was made by serology (specific IgA and IgG antibodies to yersinia outer membrane proteins (yops)), positive culture, and/or demonstration of Yersinia enterocolitica antigen in colon biopsy specimens. Patients were evaluated monthly during and after treatment up to 12 months. Of 18 patients enrolled, all could be evaluated for safety, 16 for efficacy. There was a tendency towards faster remission and relief of pain in those receiving ciprofloxacin. Y enterocolitica was eliminated from the gut associated lymphoid tissue in six of seven patients receiving ciprofloxacin compared with none of nine patients receiving placebo. Patients receiving placebo had more and prolonged circulating IgA antibodies against yops than patients treated with ciprofloxacin.

摘要

耶尔森菌引发反应性关节炎的患者被随机双盲分配,在三个月内每日口服两次500毫克环丙沙星或服用安慰剂。诊断通过血清学(针对耶尔森菌外膜蛋白(Yops)的特异性IgA和IgG抗体)、阳性培养以及/或者在结肠活检标本中证明小肠结肠炎耶尔森菌抗原来进行。在治疗期间及治疗后长达12个月的时间里,每月对患者进行评估。在纳入的18名患者中,所有患者均可进行安全性评估,16名患者可进行疗效评估。接受环丙沙星治疗的患者有更快缓解和疼痛减轻的趋势。在接受环丙沙星治疗的7名患者中,有6名患者的肠道相关淋巴组织中消除了小肠结肠炎耶尔森菌,而接受安慰剂治疗的9名患者中无一例消除。与接受环丙沙星治疗的患者相比,接受安慰剂治疗的患者针对Yops的循环IgA抗体更多且持续时间更长。

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