平均红细胞体积作为监测炎症性肠病硫嘌呤治疗替代指标的实用性。
Usefulness of mean corpuscular volume as a surrogate marker for monitoring thiopurine treatment in inflammatory bowel disease.
作者信息
Dujardin Romein W G, Meijer Berrie, de Boer Nanne K H, D'Haens Geert R, Löwenberg Mark
机构信息
aDepartment of Gastroenterology, Academic Medical Center bDepartment of Gastroenterology and Hepatology, VU University Medical Center, Amsterdam, The Netherlands.
出版信息
Eur J Gastroenterol Hepatol. 2016 Sep;28(9):991-6. doi: 10.1097/MEG.0000000000000675.
BACKGROUND
Thiopurines are commonly used drugs in inflammatory bowel disease. Intracellular levels of thiopurine metabolites [i.e. 6-thioguaninenucleotides (6-TGN)] are associated with efficacy and toxicity. Because 6-TGN measurement is not globally available, the mean corpuscular volume (MCV) has been proposed as a surrogate marker for monitoring thiopurine therapy.
AIMS
To analyze the relationship between MCV and efficacy of thiopurines, defined as either response to therapy or 6-TGN levels.
METHODS
A systematic search on PubMed was performed.
RESULTS
Fifteen studies were included. In six studies, a positive association was found between ΔMCV and 6-TGN. In four studies, it was suggested that ΔMCV can be used to predict clinical remission. In five articles, no association was found.
CONCLUSION
In the majority of articles, it was reported that ΔMCV is useful in guiding intracellular metabolite levels. However, there is insufficient evidence showing that ΔMCV can predict clinical remission.
背景
硫嘌呤类药物是炎症性肠病常用药物。硫嘌呤代谢产物（即6-硫鸟嘌呤核苷酸，6-TGN）的细胞内水平与疗效和毒性相关。由于并非全球都能检测6-TGN，因此有人提出平均红细胞体积（MCV）可作为监测硫嘌呤治疗的替代标志物。
目的
分析MCV与硫嘌呤疗效之间的关系，硫嘌呤疗效定义为对治疗的反应或6-TGN水平。
方法
在PubMed上进行了系统检索。
结果
纳入15项研究。6项研究发现ΔMCV与6-TGN之间存在正相关。4项研究表明ΔMCV可用于预测临床缓解。5篇文章未发现相关性。
结论
大多数文章报道，ΔMCV有助于指导细胞内代谢产物水平。然而，尚无充分证据表明ΔMCV可预测临床缓解。
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