环孢素A和甲氨蝶呤轮替疗法在慢性斑块型银屑病长期系统治疗中的优势

发布时间：2018-07-03 02:44

本文选题：银屑病 + 环孢素　；参考：《实用医学杂志》2017年23期

【摘要】：目的评估环孢素A和甲氨蝶呤轮替疗法的安全性。分析治疗过程中引起副反应发生的危险因素。方法本试验采用回顾性研究,选定2012年4月至2016年4月于海南省皮肤性病防治中心医院接受环孢素A及甲氨蝶呤轮替治疗的银屑病患者作为研究对象,回顾性收集了这些患者的临床数据及用药情况。所有患者在开始治疗前及随后的随访过程中均完成血常规、肝酶测定、肾功能及尿检等实验室检查。研究过程中,记录在轮替治疗中出现的任何不良事件。结果进行初筛后,共有42例银屑病患者入选。药物的平均用药时间及累积用药剂量为:环孢素A(456.79±472.14)d,(134.68±183.24)g;甲氨蝶呤(274.51±215.32)d,(418.62±435.63)mg。有4例患者在轮替治疗后出现实验室检查异常:4例(9.5%)患者出现转氨酶的异常,其中2例(4.8%)患者还同时伴有尿酸异常。所有患者的肾功能检查(血肌酐及血尿素氮)、血细胞计数及尿检均未出现异常。结论在慢性斑块型银屑病的长期系统治疗中,利用环孢素A和甲氨蝶呤轮替疗法可以很大程度上降低各类药物副作用,特别是肾脏毒性的发生。在轮替疗法治疗过程中,患者流行病学、病程长短、疾病严重程度、用药剂量及时长并不是引起药物副反应的高危因素。
[Abstract]:Objective to evaluate the safety of cyclosporine A and methotrexate replacement therapy. To analyze the risk factors of side effects in the course of treatment. Methods from April 2012 to April 2016, patients with psoriasis treated with cyclosporine A and methotrexate were selected as subjects. The clinical data and medication of these patients were collected retrospectively. All patients completed blood routine examination, liver enzyme test, renal function and urine test before and after treatment. In the course of the study, any adverse events that occurred during the rotation therapy were recorded. Results after screening, 42 patients with psoriasis were selected. The average time and cumulative dose of cyclosporine A and methotrexate were 456.79 卤472.14) d, (134.68 卤183.24 g and 274.51 卤215.32) d, (418.62 卤435.63 mg respectively. Four patients (9.5%) showed abnormal aminotransferase after rotation therapy, and 2 patients (4.8%) were accompanied with abnormal uric acid at the same time. 4 cases (9.5%) had abnormal serum aminotransferase (alt) in 4 cases (9.5%), and 2 cases (4.8%) had abnormal uric acid at the same time. No abnormalities were found in renal function (serum creatinine and blood urea nitrogen), blood cell count and urine examination in all patients. Conclusion in the long-term systematic treatment of chronic plaque psoriasis, cyclosporine A and methotrexate replacement therapy can greatly reduce the side effects of various drugs, especially the occurrence of renal toxicity. In the course of alternate therapy, epidemiology, duration of disease, severity of disease, and long dosage are not the high risk factors of side effects.
【作者单位】：海南省皮肤性病防治中心皮肤科;
【基金】：海南省卫生厅科学研究课题(编号:琼卫2010-23)
【分类号】：R758.63

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