Brynskov J, Binder V, Riis P, Lauritsen K, Schaffalitzky de Muckadell O, Freund L, Fallingborg J, Nørby Rasmussen S, Matzen P, Krag E
Department of Internal Medicine, Herlev University Hospital, Denmark.
Aliment Pharmacol Ther. 1989 Apr;3(2):135-42. doi: 10.1111/j.1365-2036.1989.tb00199.x.
Cyclosporin is a potent immunosuppressant, which has gained recent interest as a possible treatment for Crohn's disease. Chronic nephrotoxicity, however, has recently been demonstrated as a result of early treatment with high initial cyclosporin doses. We report the effect of a 3-month treatment with low-dose cyclosporin (5-7.5 mg kg-1 day-1) in 11 chronically active, therapy-resistant Crohn's disease patients. Eight of the 11 patients (72%) improved according to a clinical grading score and the Dutch Activity Index whereas 9/11 (82%) improved according to the Crohn's Disease Activity Index (P less than 0.05) after 1 month. Three patients were withdrawn despite clinical improvement. One developed arterial hypertension, one dropped out and one required surgical treatment due to a small bowel stricture. Five patients (45%) completed the treatment period with improved clinical scores. After tapering-off, two patients (18%) were better at follow-up. No serious side-effects were encountered and it is concluded that low-dose cyclosporin treatment should be further investigated in Crohn's disease.
环孢素是一种强效免疫抑制剂，最近作为克罗恩病的一种可能治疗方法而受到关注。然而，近期研究表明，早期使用高初始剂量环孢素治疗会导致慢性肾毒性。我们报告了11例慢性活动期、对治疗耐药的克罗恩病患者接受低剂量环孢素（5 - 7.5毫克/千克/天）治疗3个月的效果。11例患者中有8例（72%）根据临床分级评分和荷兰活动指数有所改善，而9/11（82%）根据克罗恩病活动指数在1个月后有所改善（P < 0.05）。尽管临床症状有所改善，但仍有3例患者退出治疗。1例出现动脉高血压，1例退出，1例因小肠狭窄需要手术治疗。5例患者（45%）完成治疗期时临床评分有所改善。减量停药后，2例患者（18%）在随访时情况较好。未出现严重副作用，因此得出结论，低剂量环孢素治疗在克罗恩病中应进一步研究。
