Cyclosporin A therapy for interstitial pneumonitis associated with rheumatic disease
Cyclosporin A therapy for interstitial pneumonitis associated with rheumatic disease
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环孢素 A 治疗风湿病相关间质性肺炎
DOI：
10.3109/s101650200054
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发表时间：
2002
影响因子：
2.2
通讯作者：
H. Hashimoto
中科院分区：
文献类型：
--
作者：
Y. Tokano;H. Ogasawara;S. Ando;T. Fujii;H. Kaneko;N. Tamura;T. Yano;K. Hirokawa;T. Fukazawa;A. Murashima;S. Kobayashi;I. Sekigawa;Y. Takasaki;N. Iida;H. Hashimoto
为了 确定环孢素A（CysA）治疗激素抵抗性间质性肺炎（IP）的疗效，我们在一项初步研究中纳入了25例各种风湿性疾病和激素抵抗性IP患者[4例类风湿性关节炎（RA），2例系统性红斑狼疮（SLE），11例多发性肌炎/皮肌炎（PM/DM），4例系统性硬化症（SSc），1例混合性结缔组织病（MCTD），3例干燥综合征（SS）]。12例患者（48%）对CysA治疗表现出持续反应，其中7例患有PM/DM，包括所谓的无肌病DM。持续反应的患者乳酸脱羟酶（LDH）水平中度升高，而死亡的患者LDH水平和缺氧程度更高。即使是血液中CysA水平低的患者也能获得持续的反应。在反应患者中，症状、胸部X线表现、动脉血氧分压和LDH水平均在不到4周后改善。总之，CysA似乎是有用的类固醇耐药IP，其持续时间短，严重程度是轻度的治疗患者。
Abstract To determine the efficacy of cyclosporin A (CysA) for the treatment of steroid-resistant interstitial pneumonitis (IP), we enrolled 25 patients with various rheumatic diseases and steroid-resistant IP in a pilot study [4 patients with rheumatoid arthritis (RA), 2 with systemic lupus erythematosus (SLE), 11 with polymyositis/dermatomyositis (PM/DM), 4 with systemic sclerosis (SSc), 1 with mixed connective tissue disease (MCTD), 3 with Sjögren syndrome (SS)]. Twelve patients (48%) showed a persistent response to CysA therapy, and 7 of them had PM/DM, including so-called amyopathic DM. Patients with a persistent response had moderately elevated lactate dehydroxygenase (LDH) levels, whereas patients who died had much higher LDH levels and hypoxia. Even patients with low blood levels of CysA achieved a persistent response. In responding patients, the symptoms, chest X-ray findings, arterial oxygen tension, and LDH level all improved after less than 4 weeks. In conclusion, CysA seem to be useful for treating patients with steroid-resistant IP, whose duration is short and severity is mild.