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世界核心医学期刊文摘（胃肠病学分册） 2005年第7期1卷 40-41页

作者： Glazier K.D. palance a.l. Griffel l.H. Das K.M. 樊菁 UMDNJ- Robert Wood Johnson Med. Sch. 1 Robert Wood Johnson Place New Brunswick NJ 08903 United States Dr.

Goals: To report the 10- year experience of a single center in treating pati ents with refractory inflammatory bowel disease (IBD) with relatively lower dose of 6- mercaptopurine (6- MP). Study: The charts of 285 patients with IBD (Cro hn’ s disease 160 and ulcerative colitis 125) receiving 6- MP were reviewed. C linical response, subsequent breakthrough while taking 6- MP, and relapse rates when 6- MP was discontinued and side effects were assessed. Results: Ninety- three percent of the patients were taking 50 to 75 mg/day of 6- MP. Complete re mission was achieved in 62% , partial remission in 14.5% , and fa.l.re to achi eve remission in 23.5% of the patients. Of complete responders, 27.5% had br eakthrough while continuing 6- MP. Nine percent of those that achieved a comple te remission experienced a relapse after 6- MP was discontinued. Side effects i ncluded leukopenia (11.2% ), abnormal liver function tests (3.8% ), various in fections, including pneumonia (3.1% ), pancreatitis (2.5% ), nausea (2.1% ), headache (2.8% ), fever (1.4% ), hair loss (1% ), and rash (0.7% ). Two canc ers occurred while taking 6- MP: melanoma on the finger and a fatal colonic lym phoma. Four patients continued 6- MP throughout pregnancies and had normal outc omes. Conclusions: In our experience 6- MP is relatively safe and appears to be as effective at a.l.wer dosage (0.84 mg/kg per day) compared with the recommend ed higher dosage (1- 1.5 mg/kg per day), when leukopenia was more frequent. Ser ious side effects, although rare, need to be monitored.

关键词：炎症性肠病单中心克罗恩病溃疡性结肠炎结肠淋巴瘤临床反应复发率黑色素瘤白细胞减少正常分娩

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