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重新评估异维A酸治疗痤疮期间进行常规实验室监测的必要性。

Re-evaluating the necessity of routine laboratory monitoring during isotretinoin therapy for acne.

作者信息

Zhu Yun-Xia, Wu Liang, Zhu Sheng-Cai, Wang Xiu-Ping, Zhang Deng, Tan Yan-Ping, Ouyang Xiao-Liang, Li Chun-Ming

机构信息

Department of Dermatology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang 330006, Jiangxi Province, China.

Department of Dermatology, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang 330000, Jiangxi Province, China.

出版信息

World J Clin Cases. 2024 Oct 6;12(28):6237-6240. doi: 10.12998/wjcc.v12.i28.6237.

Abstract

In this letter, we discuss the topic of necessity of routine laboratory monitoring during isotretinoin treatment for acne. According to Park and colleagues, it is advisable to monitor the levels of triglycerides, alanine aminotransferase, and aspartate aminotransferase every 5 to 6 months. Additionally, the levels of total cholesterol and low-density lipoprotein should be checked within the first two months of treatment. Isotretinoin is a commonly prescribed agent mainly used to treat acne. Despite its high effectiveness, it necessitates regular monitoring of laboratory parameters due to its side effect profile. Currently, there remains a lack of consensus on the appropriate frequency for monitoring these parameters during treatment with isotretinoin. This letter will provide insight into this complex and controversial topic. Based on existing literature, we concluded that the incidence of changes in lipid and liver aminotransferase levels during isotretinoin treatment for acne was low and likely clinically insignificant. For generally healthy people, we recommend testing lipid and liver profiles once at baseline and a second time at the peak dosage. However, frequent testing might still be beneficial in certain populations of patients.

摘要

在这封信中,我们讨论了异维A酸治疗痤疮期间进行常规实验室监测的必要性这一话题。根据帕克及其同事的观点,建议每5至6个月监测一次甘油三酯、丙氨酸氨基转移酶和天冬氨酸氨基转移酶的水平。此外,应在治疗的前两个月内检查总胆固醇和低密度脂蛋白的水平。异维A酸是一种常用药物,主要用于治疗痤疮。尽管其疗效显著,但由于其副作用,需要定期监测实验室参数。目前,对于异维A酸治疗期间监测这些参数的合适频率仍缺乏共识。这封信将深入探讨这个复杂且有争议的话题。基于现有文献,我们得出结论,异维A酸治疗痤疮期间脂质和肝转氨酶水平变化的发生率较低,可能在临床上无显著意义。对于一般健康的人,我们建议在基线时检测一次脂质和肝功能指标,在达到峰值剂量时再检测一次。然而,对于某些患者群体,频繁检测可能仍然有益。

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Isotretinoin's Effect on Fasting Lipid Profile in Acne Patients.异维 A 酸对痤疮患者空腹血脂谱的影响。
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本文引用的文献

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Guidelines of care for the management of acne vulgaris.寻常痤疮治疗指南。
J Am Acad Dermatol. 2024 May;90(5):1006.e1-1006.e30. doi: 10.1016/j.jaad.2023.12.017. Epub 2024 Jan 30.

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