Gavaler J S, Delemos B, Belle S H, Heyl A E, Tarter R E, Starzl T E, Gavaler C, van Thiel D H
Department of Medicine, University of Pittsburgh School of Medicine, Pennsylvania 15261.
Dig Dis Sci. 1991 Mar;36(3):321-8. doi: 10.1007/BF01318204.
To assess whether or not liver transplantation and subsequent immunosuppression with cyclosporine and prednisone affect ulcerative colitis symptomatology, we surveyed by questionnaire all 23 surviving patients with pretransplant colonoscopy-documented ulcerative colitis who were transplanted for primary sclerosing cholangitis between June 1982 and September 1985. At follow-up [89.8 +/- 7.6 weeks (mean +/- SEM], all six patients who had had asymptomatic colonoscopy-documented ulcerative colitis reported continued ulcerative colitis quiescence. Among the 17 patients who had had symptomatic colonoscopy-documented ulcerative colitis at time of liver transplantation, 88.2% reported improvement in overall ulcerative colitis severity (P less than 0.001), with significant improvement in the frequency of bowel movements reported by 100%, in crampy abdominal pain by 87.5%, in bowel urgency by 75%, in the occurrence of pus or mucus in stool by 87.5%, in the incidence of ulcerative colitis flares by 81.8%, and in the number of days unable to function normally due to ulcerative colitis symptoms by 78.6% (all at least P less than 0.01). These data demonstrate that ulcerative colitis symptom severity significantly improves following liver transplantation with immunosuppression with cyclosporine and prednisone.
为评估肝移植及随后使用环孢素和泼尼松进行免疫抑制是否会影响溃疡性结肠炎的症状，我们通过问卷调查了1982年6月至1985年9月期间因原发性硬化性胆管炎接受肝移植的所有23例存活患者，这些患者移植前经结肠镜检查确诊为溃疡性结肠炎。在随访期间[89.8±7.6周（均值±标准误）]，所有6例结肠镜检查确诊为无症状溃疡性结肠炎的患者报告溃疡性结肠炎持续缓解。在肝移植时结肠镜检查确诊为有症状溃疡性结肠炎的17例患者中，88.2%报告溃疡性结肠炎总体严重程度有所改善（P<0.001），其中100%报告排便频率显著改善，87.5%报告痉挛性腹痛改善，75%报告便急改善，87.5%报告粪便中出现脓液或黏液的情况改善，81.8%报告溃疡性结肠炎发作次数改善，78.6%报告因溃疡性结肠炎症状而无法正常工作的天数改善（所有P值均至少<0.01）。这些数据表明，肝移植并使用环孢素和泼尼松进行免疫抑制后，溃疡性结肠炎的症状严重程度显著改善。
