Theodor E, Niv Y, Bat L
Am J Gastroenterol. 1981 Sep;76(3):262-6.
A retrospective study of 35 patients with ulcerative colitis is presented. The patients were treated with Imuran, alone or combined with corticosteroids, in single or repeated courses, over a period of 11 years. The usual indication for Imuran treatment was nonresponse to Azulfidine or corticosteroids. Criteria for response to treatment were: 1. decrease in stool frequency, 2. decrease in frequency and amount of rectal bleeding and 3. weight gain. Improvement was noted on the average two weeks after the start of Imuran therapy and 62% of the patients had complete remission afer 1.7 months. When patient-months of remission and activity were compared on different therapies. Imuran, both alone and combined with steroids, was clearly superior to nontreatment or steroid therapy. With the exception of two patients with fulminant disease, who developed fatal septicemia on Imuran therapy, there were no serious complications. Seven patients eventually underwent colectomy and one patient developed carcinoma of the colon. Our results indicate that there is a definite place for Imuran in the treatment of selected patients with ulcerative colitis.
本文对35例溃疡性结肠炎患者进行了回顾性研究。这些患者在11年的时间里，单独或联合使用皮质类固醇，单次或重复疗程使用硫唑嘌呤进行治疗。硫唑嘌呤治疗的常见指征是对柳氮磺胺吡啶或皮质类固醇无反应。治疗反应的标准为：1. 大便频率降低；2. 直肠出血频率和出血量降低；3. 体重增加。在硫唑嘌呤治疗开始后平均两周观察到病情改善，62%的患者在1.7个月后完全缓解。当比较不同治疗方法的缓解和活动患者月数时，单独使用硫唑嘌呤以及联合使用类固醇的硫唑嘌呤治疗明显优于未治疗或类固醇治疗。除了两名暴发性疾病患者在硫唑嘌呤治疗中发生致命性败血症外，没有严重并发症。7例患者最终接受了结肠切除术，1例患者发生了结肠癌。我们的结果表明，硫唑嘌呤在治疗部分溃疡性结肠炎患者中具有明确的地位。
