Mulder C J, van den Hazel S J
Department of Gastroenterology, Rijnstate Hospital, Arnhem, The Netherlands.
Mediators Inflamm. 1998;7(3):135-6. doi: 10.1080/09629359891027.
Mesalazine is widely used in the treatment of inflammatory bowel disease. Little is known about the dose-response relationship and about possible dose related side effects. In ulcerative colitis higher dosages of mesalazine (3 g) are more effective in maintaining a remission than lower dosages (1.5 g). In mild to moderately active ulcerative colitis, studies also indicate that higher dosages might be more effective in inducing remission. Dose-comparing studies in Crohn's disease are even more sparse, but the available results indicate higher efficacy at higher dose levels. None of the known side effects of mesalazine are clearly dose-related. A pH-dependent release system, however, can cause a sudden release of high doses of mesalazine. Consequent peak levels in serum have been implicated in mesalazine induced nephrotoxicity. In conclusion, despite the current practice of using increasing dosages of mesalazine in inflammatory bowel disease, both efficacy and safety have been established tentatively.
美沙拉嗪广泛用于治疗炎症性肠病。关于其剂量反应关系以及可能的剂量相关副作用，人们了解甚少。在溃疡性结肠炎中，较高剂量的美沙拉嗪（3克）在维持缓解方面比较低剂量（1.5克）更有效。在轻度至中度活动性溃疡性结肠炎中，研究还表明较高剂量在诱导缓解方面可能更有效。关于克罗恩病的剂量比较研究更为稀少，但现有结果表明在较高剂量水平下疗效更高。美沙拉嗪已知的副作用中，没有一种与剂量有明确关联。然而，pH依赖释放系统可导致高剂量美沙拉嗪突然释放。血清中的相应峰值水平与美沙拉嗪诱发的肾毒性有关。总之，尽管目前在炎症性肠病中使用美沙拉嗪剂量不断增加的做法，但疗效和安全性都只是初步确定的。
