COLCHICINE IN THE TREATMENT OF CIRRHOSIS OF THE LIVER
COLCHICINE IN THE TREATMENT OF CIRRHOSIS OF THE LIVER
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DOI：
10.1056/nejm198806303182602
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发表时间：
1988-06-30
影响因子：
158.5
通讯作者：
ROJKIND, M
中科院分区：
文献类型：
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作者：
KERSHENOBICH, D;VARGAS, F;ROJKIND, M
有初步证据表明，秋水仙碱，一种胶原合成的抑制剂，可能对治疗肝硬变有益。为了评估秋水仙碱(每天1毫克，每周5天)在肝硬变治疗中的应用，我们进行了一项随机、双盲、安慰剂对照试验，对100名患者进行了长达14年的跟踪调查。其中45例为酒精性肝硬变，41例为肝炎后肝硬变，其余14例为其他原因的肝硬变。92%的患者可以获得组织学研究。其中A级患者73例，B级患者26例，C级患者1例。54例患者接受秋水仙碱治疗，46例患者接受安慰剂治疗。秋水仙碱组的总体生存率明显好于安慰剂组(中位生存期分别为11年和3.5年；P<；0.001)。秋水仙碱组和安慰剂组的累积5年生存率分别为75%和34%；相应的10年生存率分别为56%和20%。在接受秋水仙碱治疗的30名患者中，9名患者的肝组织学有所改善，2名患者的肝脏正常，7名患者有轻微的门脉纤维化。在接受两次或两次以上活检的14名安慰剂组成员中，没有观察到组织学上的改善。两组均未观察到不良反应。
There is primary evidence that colchicine, an inhibitor of collagen synthesis, may be beneficial in the treatment of cirrhosis of the liver. To evaluate the use of colchicine (1 mg per day, five days per week) in the treatment of hepatic cirrhosis, we performed a randomized, double-blind, placebo-controlled trial in which 100 patients were followed for up to 14 years. Forty-five patients had alcoholic cirrhosis, 41 had posthepatitic cirrhosis, and the remaining 14 had cirrhosis with various other causes. Histologic studies were available for 92 percent of patients. Seventy-three patients were in Child-Turcotte class A, 26 were in class B, and one was in class C. Fifty-four patients received colchicine, and 46 received placebo. The overall survival in the colchicine group was markedly better than in the placebo group (median survival, 11 and 3.5 years, respectively; P < 0.001). The cumulative 5-year survival rates were 75 percent in the colchicine group and 34 percent in the placebo group; the corresponding 10-year survival rates were 56 percent and 20 percent. Among the 30 patients treated with colchicine who underwent repeated liver biopsies, histologic improvement was seen in 9; the liver appeared normal in 2, and 7 had minimal portal fibrosis. No histologic improvement was observed in the 14 members of the placebo group who had two or more biopsies. Few side effects were observed in either group.