接受低剂量脉冲甲氨蝶呤治疗类风湿关节炎患者的肝脏组织学
Liver histology in patients receiving low dose pulse methotrexate for the treatment of rheumatoid arthritis.
作者信息
Willkens R F, Leonard P A, Clegg D O, Tolman K G, Ward J R, Marks C R, Greene M L, Roth G J, Jackson C G, Cannon G W
机构信息
Harborview Medical Center, University of Washington, Seattle 98104.
出版信息
Ann Rheum Dis. 1990 Aug;49(8):591-3. doi: 10.1136/ard.49.8.591.
Abstract
The liver histology of 52 patients treated with intermittent low dose pulse methotrexate for rheumatoid arthritis was evaluated using a modification of the Roenigk grading system. Patients studied had had an average of 3.2 years of treatment or had received 1.7 g methotrexate. No patient had cirrhosis; 15 (29%) patients had evidence of mild fibrosis. Histological abnormalities were not predicted by liver function test changes, with the exception that hypoalbuminaemia occurred in 60% of those with grade IV (modified criteria) findings. The need for liver biopsy in patients with rheumatoid arthritis treated with methotrexate before two years or 1500 mg of treatment has not been established. Whether serial liver biopsies will be needed beyond this time has yet to be determined.
摘要
采用改良的罗宁克分级系统对52例接受间歇性小剂量脉冲甲氨蝶呤治疗类风湿关节炎的患者的肝脏组织学进行了评估。所研究的患者平均接受了3.2年的治疗或已接受1.7克甲氨蝶呤治疗。没有患者出现肝硬化；15例（29%）患者有轻度纤维化的证据。除了IV级（改良标准）结果的患者中有60%出现低白蛋白血症外，肝功能测试变化并不能预测组织学异常。对于在两年或1500毫克治疗之前接受甲氨蝶呤治疗的类风湿关节炎患者，尚未确定是否需要进行肝活检。在此之后是否需要进行系列肝活检尚未确定。
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