Objective: To clarify the efficacy and safety of cyclosporine A (CsA) as salvage therapy in patients with severe active ulcerative colitis (UC) and refractory to steroids. Methods: A total of 24 severe active UC patients refractory to steroids and hospitalized from 2006 to 2012, were retrospectively enrolled.Data including demographic features, clinical manifestations, laboratory tests and medications were collected. Results: CsA was effective in 15(62.5%) patients, who did not receive colectomy during 12-week administration. This regimen was tolerable in most patients.Twelve (50.0%) patients reported 16 adverse events, but only one patient withdrew CsA due to intolerance.The rates of adverse events in initial intravenous CsA including 4 mg·kg(-1)·d(-1,) 3 mg·kg(-1)·d(-1) and 2 mg·kg(-1)·d(-1) were 2/2, 9/17 and 1/5 respectively.Responders had higher white blood cell count compared with non-responders (P= 0.045). Conclusions: CsA could be an effective alternative regimen to colectomy in severe active UC patients who are refractory to steroids.
目的： 探讨环孢素A(CsA)治疗糖皮质激素抵抗(激素抵抗)的重度溃疡性结肠炎(UC)患者的疗效及安全性。 方法： 自2006年3月至2012年10月于北京协和医院住院治疗的激素抵抗的重度活动且应用CsA转化治疗的成人UC患者24例，收集其人口学特点、临床表现、辅助检查以及药物治疗等资料。治疗有效指接受CsA治疗后临床症状好转，无不可耐受的不良反应，且能在治疗后12周内避免手术治疗。 结果： 患者平均发病年龄为33.8岁，男女比例为13∶11，15例(62.5%)患者治疗有效。12例(50.0%)患者出现16人次药物不良反应，仅1例因无法耐受立即停药。CsA初始剂量为4、3和2 mg·kg(－1)·d(－1)的患者药物不良反应的发生率分别2/2、9/17和1/5。治疗无效组CsA使用前血白细胞计数显著低于治疗有效组(P＝0.045)。 结论： CsA应用于我国激素抵抗的重度UC患者的转化治疗，可有效降低治疗3个月内结直肠手术率且安全性好。.
Keywords: Colitis, ulcerative; Cyclosporine A; Retrospective studies; Steroid refractory.