Azathioprine in the treatment of children with inflammatory bowel disease.
Azathioprine in the treatment of children with inflammatory bowel disease.
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DOI：
10.1016/s0022-3476(05)83349-9
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发表时间：
1990-11
期刊：
影响因子：
--
通讯作者：
M. Verhave;Harland S. Winter;R. J. Grand
中科院分区：
文献类型：
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作者：
M. Verhave;Harland S. Winter;R. J. Grand
在6年的时间里，我们治疗了21例患者硫唑嘌呤，2毫克/公斤/天，作为他们的习惯方案的辅助。9例患者患有溃疡性结肠炎，12例患者患有克罗恩病;患者的年龄范围为3至17岁。硫唑嘌呤治疗开始前的中位病程为2年，中位随访时间为2年。16例患者似乎对硫唑嘌呤治疗有反应：每个疾病组中有6例患者完全缓解，4例患者（1例溃疡性结肠炎和3例克罗恩病）部分缓解。两名溃疡性结肠炎患者和三名克罗恩病患者没有反应。溃疡性结肠炎患者的中位缓解时间不到3个月，克罗恩病患者的中位缓解时间不到4个月。所有对硫唑嘌呤治疗有反应的患者均可减少皮质类固醇剂量。这种药只有极轻微的副作用。我们的结论是，硫唑嘌呤是一种有效的治疗儿童炎症性肠病的药物，但由于其长期安全性仍存在问题，其使用应保留给儿童难治性疾病或严重和不可接受的副作用的皮质类固醇。
During a 6-year period, we treated 21 patients with azathioprine, 2 mg/kg/day, as an adjunct to their customary regimen. Nine patients had ulcerative collits and 12 patients had Crohn disease; the patients' ages ranged from 3 to 17 years. The median duration of disease before the start of azathioprine therapy was 2 years, and median follow-up was 2 years. Sixteen patients seemed to respond to azathioprine therapy: six patients in each disease group had complete responses and four patients (one with ulcerative colitis and three with Crohn disease) had partial responses. Two patients with ulcerative colitis and three patients with Crohn disease did not respond. The median time untill patients responded was less than 3 months for patients with ulcerative colitis and 4 months for those with Crohn disease. Reduction of corticosteroid dose was possible for all patients who responded to azathioprine therapy. Only minimal side effects were attributable to the drug. We conclude that azathioprine is an effective adjunctive agent for the treatment of inflammatory bowel disease in childhood, but because questions remain regarding its long-term safety, its use should be reserved for children with refractory disease or severe and unacceptable side effects of corticosteroids.