静脉注射甲基强的松龙脉冲疗法治疗自身免疫性肝炎患儿。
Intravenous methylprednisolone pulse therapy for children with autoimmune hepatitis.
机构信息
Department of Pediatrics, Atami Hospital, International University of Health and Welfare, 13-1, Higashikaigancho, Atami City, Shizuoka 413-0012, Japan; Department of Pathology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
出版信息
Hepatol Res. 2006 Mar;34(3):187-92. doi: 10.1016/j.hepres.2005.12.002. Epub 2006 Jan 31.
OBJECTIVE
To estimate an efficacy of intravenous methylprednisolone pulse therapy (m-PSL) and the occurrence of corticosteroid-related side effects in children with autoimmune hepatitis (AIH), compared with oral corticosteroid therapy.
STUDY DESIGN
The subjects consisted of nine children with AIH. Patients were divided into two groups. Group 1 was consisted of four patients who were treated with conventional oral prednisone therapy without m-PSL. Group 2 was consisted of five children who were treated with m-PSL as an induction therapy and maintained on oral prednisone.
RESULTS
The median duration needed for normalization of alanine aminotransferase was 285 days (range 18-617 days) in group 1 and 54 days (range 15-116 days) in group 2. The most frequent side effects were obesity and growth retardation. The Z-score in group 1 tended to be lower than in group 2 and body mass index in group 1 tended to be higher than in group 2.
CONCLUSION
The m-PSL may become a safe and effective therapy for children with AIH. Further study is needed to establish the appropriate therapy for AIH in children.
目的
比较静脉注射甲泼尼龙脉冲疗法（m-PSL）和皮质类固醇相关副作用的发生情况，评估其在儿童自身免疫性肝炎（AIH）中的疗效，与口服皮质类固醇治疗相比。
研究设计
本研究对象包括 9 名 AIH 患儿。将患者分为两组。组 1 由 4 名未接受 m-PSL 的常规口服泼尼松治疗的患者组成。组 2 由 5 名接受 m-PSL 诱导治疗并维持口服泼尼松的患儿组成。
结果
组 1 患者中丙氨酸氨基转移酶恢复正常所需的中位数时间为 285 天（范围 18-617 天），组 2 为 54 天（范围 15-116 天）。最常见的副作用是肥胖和生长迟缓。组 1 的 Z 评分趋于低于组 2，而组 1 的体重指数趋于高于组 2。
结论
m-PSL 可能成为治疗儿童 AIH 的一种安全有效的方法。需要进一步研究以确定儿童 AIH 的适当治疗方法。
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