Marbet U A, Gyr K, Stalder G A
Schweiz Med Wochenschr. 1986 Jul 19;116(29):962-3.
The pathogenesis of Crohn's disease is unknown, but immunologic mechanisms appear to play at least a partial role. Prompted by favourable experience with cyclosporin A in autoimmune diseases, the authors used it in steroid resistant acute Crohn's disease and started a pilot study comparing cyclosporin A with prednisone. Initial experience shows that cyclosporin A is effective in at least some patients with acute Crohn's disease. Side effects have thus far been minimal. However, oral dosage of the drug is difficult and regular determinations of the trough blood concentration are indispensable. A trough blood concentration of 200 ng/ml appears to be necessary to obtain full therapeutic activity. The lower antipyretic effect of cyclosporin A compared to prednisone may initially mask a favourable therapeutic effect. The effectiveness of cyclosporin A compared with prednisone cannot yet be evaluated.
克罗恩病的发病机制尚不清楚，但免疫机制似乎至少起了部分作用。鉴于环孢素A在自身免疫性疾病中的良好疗效，作者将其用于激素抵抗型急性克罗恩病，并开展了一项将环孢素A与泼尼松进行比较的试点研究。初步经验表明，环孢素A对至少部分急性克罗恩病患者有效。迄今为止，副作用极小。然而，该药物的口服剂量难以掌握，定期测定血药谷浓度必不可少。要获得充分的治疗活性，血药谷浓度似乎需要达到200 ng/ml。与泼尼松相比，环孢素A较低的退热作用最初可能会掩盖其良好的治疗效果。环孢素A与泼尼松相比的有效性尚无法评估。
