George J, Present D H, Pou R, Bodian C, Rubin P H
Department of Medicine, Mount Sinai Medical Center, New York, New York, USA.
Am J Gastroenterol. 1996 Sep;91(9):1711-4.
To determine the long term outcome of ulcerative colitis in patients treated with 6-MP.
The charts of 105 chronic refractory ulcerative colitis patients treated with 6-MP from 1973-1992 were reviewed. The focus was placed on clinical response, subsequent breakthrough while maintaining 6-MP, and relapse rates when 6-MP was discontinued.
Complete clinical remission was achieved in 68 patients (65%), partial remission was achieved in 25 patients (24%), and 12 patients (11%) failed to achieve remission. Of complete responders who continued 6-MP, 35% had a breakthrough, although complete remission was restored in 88% with the majority not requiring systemic steroids. Of complete responders who discontinued 6-MP, 87% subsequently relapsed. There were few major toxicities associated with 6-MP use.
6-MP is a reasonably safe and effective treatment for refractory ulcerative colitis. Patients who discontinue 6-MP after successful treatment have high relapse rates, therefore, 6-MP must be maintained long term to sustain remission.
确定接受6-巯基嘌呤（6-MP）治疗的溃疡性结肠炎患者的长期预后。
回顾了1973年至1992年期间接受6-MP治疗的105例慢性难治性溃疡性结肠炎患者的病历。重点关注临床反应、维持6-MP治疗期间的后续病情恶化情况以及停用6-MP后的复发率。
68例患者（65%）实现了完全临床缓解，25例患者（24%）实现了部分缓解，12例患者（11%）未实现缓解。在继续使用6-MP的完全缓解者中，35%出现了病情恶化，尽管88%的患者恢复了完全缓解，且大多数患者无需使用全身性类固醇药物。在停用6-MP的完全缓解者中，87%随后复发。与使用6-MP相关的严重毒性反应很少。
6-MP是治疗难治性溃疡性结肠炎的一种相当安全有效的药物。成功治疗后停用6-MP的患者复发率很高，因此，必须长期维持使用6-MP以维持缓解状态。
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