Takenami T, Sakaguchi K, Nishimura M, Miyake Y, Miyashita M, Terao M, Fujiwara A, Tsuji T
Department of Medicine and Medical Science, Okayama University Graduate School of Medicine and Dentistry, Japan.
Acta Med Okayama. 2001 Dec;55(6):341-7. doi: 10.18926/AMO/32001.
This study evaluated the effects of azathioprine in combination with low-dose prednisolone in the management of patients with intractable autoimmune hepatitis. Thirteen patients with intractable autoimmune hepatitis who had an incomplete or arrested response to conventional prednisolone therapy, or who relapsed during prednisolone maintenance therapy were additionally administered 50 or 100 mg/day of azathioprine in combination with prednisolone. This regimen reliably induced complete remission in 12 of 13 patients, and these 12 remained in remission during the follow-up period with maintenance therapy of 50 mg/day of azathioprine in combination with 5 mg/day of prednisolone. The findings of the current study indicate that the azathioprine and low-dose prednisolone combined therapy may offer a satisfactory alternative therapy for patients with intractable autoimmune hepatitis who have an incomplete or arrested response to conventional prednisolone therapy, or who relapse during prednisolone maintenance therapy.
本研究评估了硫唑嘌呤联合小剂量泼尼松龙治疗难治性自身免疫性肝炎患者的效果。13例对传统泼尼松龙治疗反应不完全或病情停滞，或在泼尼松龙维持治疗期间复发的难治性自身免疫性肝炎患者，额外给予硫唑嘌呤50或100mg/天联合泼尼松龙治疗。该方案使13例患者中的12例可靠地实现了完全缓解，这12例患者在后续随访期间通过每天50mg硫唑嘌呤联合5mg泼尼松龙的维持治疗保持缓解状态。本研究结果表明，对于对传统泼尼松龙治疗反应不完全或病情停滞，或在泼尼松龙维持治疗期间复发的难治性自身免疫性肝炎患者，硫唑嘌呤与小剂量泼尼松龙联合治疗可能是一种令人满意的替代治疗方法。
