小剂量短疗程泼尼松治疗顽固性复发性阿弗他溃疡的疗效及免疫改变

发布时间：2018-05-31 05:10

本文选题：顽固性复发性阿弗他溃疡 + 泼尼松　；参考：《口腔医学研究》2017年01期

【摘要】：目的:探讨小剂量短疗程泼尼松治疗顽固性复发性阿弗他溃疡(顽固性RAU)的临床疗效及对免疫指标调节的作用。方法:选择37例顽固性RAU的患者,小剂量短疗程口服泼尼松治疗1个月,前20d10mg/d,之后5d减量为7.5mg/d,最后5d减量为5mg/d,治疗前后检查血常规、肝肾功能、外周血体液和细胞相关免疫指标,观察治疗1个月、停药2个月后临床疗效及不良反应,治疗1个月后免疫指标改变。结果:小剂量短疗程口服泼尼松治疗顽固性RAU的治疗1个月后总有效率为100%,停药2个月后总有效率为91.4%,治疗1个月后外周血免疫球蛋白及补体(IgG、IgA、IgM、IgE和C4)水平降低(P0.05),免疫细胞(B、T淋巴细胞及NK细胞)比例未出现明显差异。结论:采用小剂量短疗程泼尼松治疗顽固性RAU有较好的疗效,可延长溃疡发作间歇期,降低溃疡发作的数目、面积及疼痛程度,未见不良反应的发生。调节体液免疫可能是泼尼松治疗顽固性RAU的途径之一。
[Abstract]:Objective: to investigate the clinical effect of low dose prednisone in the treatment of refractory recurrent aphthous ulcer (Rau) and its effect on immune index regulation. Methods: 37 patients with intractable RAU were treated with prednisone for 1 month, the first 20 days after 10 mg / d, the last 5 days as 7.5 mg / d, and the last 5 days as 5 mg / d. The blood routine, liver and kidney function were examined before and after treatment. The clinical efficacy and adverse reactions were observed after 1 month of treatment and 2 months after treatment, and the changes of immune indexes were observed after 1 month of treatment. Results: the total effective rate of low-dose short course oral prednisone for intractable RAU was 100% after one month, and 91.4 after 2 months after withdrawal. After one month of treatment, the levels of peripheral blood immunoglobulin and complement IgGA-IgMN IgE and C _ 4 decreased (P 0.05). There was no significant difference in the percentage of T lymphocytes and NK cells in immune cells. Conclusion: low dose prednisone is effective in the treatment of refractory RAU. It can prolong the interval of ulcer attack, reduce the number, area and degree of pain of ulcer attack, and there is no adverse reaction. Regulation of humoral immunity may be one of the pathways of prednisone in the treatment of refractory RAU.
【作者单位】：南京大学医学院附属口腔医院·南京市口腔医院口腔黏膜病科;南京大学医学院附属口腔医院·南京市口腔医院牙体牙髓病科;
【基金】：国家自然科学基金项目(编号:81570978;81400521) 江苏省临床医学科技专项(编号:BL2014018) 南京市科技计划项目(编号:201402033)
【分类号】：R781.5

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