Long-term outcome of patients with interstitial cystitis treated with low dose cyclosporine A
Long-term outcome of patients with interstitial cystitis treated with low dose cyclosporine A
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DOI：
10.1097/01.ju.0000125139.91203.7a
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发表时间：
2004-06-01
影响因子：
6.6
通讯作者：
Ruutu, MJ
中科院分区：
文献类型：
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作者：
Sairanen, J;Forsell, T;Ruutu, MJ
目的：我们评估了接受环孢素A治疗至少一年的间质性膀胱炎患者。记录患者排尿表症状改善情况及膀胱疼痛的主观表现。材料和方法：符合美国国家糖尿病与消化肾脏病研究所间质性膀胱炎诊断标准的患者23例，女性20例，男性3例。随访时患者年龄为65.7±7.6岁(平均+/-SD)。平均随访60.8+/-35.7个月。在开始环孢素A治疗之前，在没有临床帮助的情况下尝试了多种一线治疗方法。结果：治疗前24小时内排尿次数为20.8+/-6.3个。在环孢素A治疗一年后，其下降到10.2+/-3.8%(p<；0.001)。最大膀胱容量在一年内从161.8±74.6ml增加到360.7+/-99.3ml(p<；0.001)。平均尿量由101.4±42.7ml增至246.4±97.9ml(p<；0.001)。这种效果在整个随访过程中一直保持不变。23例患者中，20例报告环孢素A治疗后无膀胱疼痛，11例因临床疗效好而停止治疗。9例患者症状在几个月内复发，但在重新开始环孢素A治疗后再次消失。结论：环孢素A治疗间质性膀胱炎安全有效。取得的治疗效果长期维持。在大多数情况下，停药会导致症状复发。
Purpose: We evaluated patients with interstitial cystitis who had been on cyclosporine A treatment for at least a year. Symptom improvement on micturition charts and subjective expression of bladder pain were recorded. Side effects and safety of medication were evaluated.Materials and Methods: A total of 23 patients (20 females and 3 males) fulfilling National Institute for Diabetes and Digestive and Kidney Diseases criteria of interstitial cystitis were included in this study. Age of patients at followup, was 65.7 +/- 7.6 years (mean +/- SD). Mean followup, was 60.8 +/- 35.7 months. Before starting cyclosporine A treatment multiple first line therapies had been tried without clinical help.Results: The number of voidings in 24 hours was 20.8 +/- 6.3 before treatment. After a year of cyclosporine A treatment it was decreased to 10.2 +/- 3.8 (p < 0.001). Maximal bladder capacity increased from 161.8 +/- 74.6 to 360.7 +/- 99.3 ml in a year (p < 0.001). Mean voided volume increased from 101.4 +/- 42.7 to 246.4 +/- 97.9 ml (p < 0.001). The effect was maintained throughout followup. Of 23 total patients 20 reported no bladder pain on cyclosporine A treatment and 11 patients stopped treatment due to a good clinical effect. In 9 patients symptoms recurred within months but disappeared again after cyclosporine A treatment was restarted. Side effects of medication were infrequent.Conclusions: Cyclosporine A treatment was safe and effective in treating interstitial cystitis. The achieved therapeutic effect was maintained in the long term. Cessation of medication led to recurrence of symptoms in most cases.