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硫唑嘌呤用于炎症性肠病,是一种安全的替代药物吗?

Azathioprine in inflammatory bowel disease, a safe alternative?

作者信息

Tanis A A

机构信息

Department of Gastroenterology and Hepatology, Internal Medicine II, Erasmus University Hospital-Dijkzigt, Rotterdam, The Netherlands.

出版信息

Mediators Inflamm. 1998;7(3):141-4. doi: 10.1080/09629359891045.

Abstract

Azathioprine and its metabolite 6-mercaptopurine are effective in the treatment of inflammatory bowel disease. They are mostly used for reduction of the use of steroids, maintenance therapy after remission induction by cyclosporin and treatment of fistulae in Crohn's disease. Adverse effects occur in about 15% of patients. The main side effects are pancreatitis, allergic reactions, fever and bone marrow suppression. Symptoms, management and prevention are discussed. A blood monitoring schedule is suggested. Azathioprine and 6-mercaptopurine seem to be safe in pregnancy. There may be a slight increased risk for developing a non-Hodgkin's lymphoma.

摘要

硫唑嘌呤及其代谢产物6-巯基嘌呤对炎性肠病有效。它们主要用于减少类固醇的使用、环孢素诱导缓解后的维持治疗以及克罗恩病瘘管的治疗。约15%的患者会出现不良反应。主要副作用为胰腺炎、过敏反应、发热和骨髓抑制。文中讨论了症状、处理方法及预防措施。并建议了血液监测方案。硫唑嘌呤和6-巯基嘌呤在孕期似乎是安全的。患非霍奇金淋巴瘤的风险可能略有增加。

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本文引用的文献

1
Pellagra, azathioprine and inflammatory bowel disease.糙皮病、硫唑嘌呤与炎症性肠病
Clin Exp Dermatol. 1997 Jan;22(1):44-5. doi: 10.1046/j.1365-2230.1997.1930606.x.
9
Azathioprine and 6-mercaptopurine in Crohn disease. A meta-analysis.硫唑嘌呤和6-巯基嘌呤用于克罗恩病的荟萃分析
Ann Intern Med. 1995 Jul 15;123(2):132-42. doi: 10.7326/0003-4819-123-2-199507150-00009.

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