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环胺在耐火性自身免疫性肝炎和自身免疫性肝炎同时存在的肝外自身免疫性疾病中
AnJi Xiong1, SuTing Li2, XiaoYan Dou3
1Department of Rheumatology and Immunology, Nanchong Central Hospital, The Affiliated Nanchong Central Hospital of North Sichuan Medical College, Nanchong Hospital of Bejjing Anzhen Hospital Capital Medical University, Nanchong, Sichuan Province, China; Inflammation and Immunology Key Laboratory of Nanchong City, Nanchong, Sichuan Province, China; Nanchong Central Hospital (Nanchong Clinical Research Center), Nanchong, Sichuan Province, China.
环胺 (CYC) 是一种安全有效的治疗方法,可用于困难的自身免疫性肝炎 (AIH) 病例,其缓解率很高. 当标准治疗失败时,这种疗法提供了一个潜在的替代方案,特别是在患有并存自身免疫疾病的患者中.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 自身免疫性肝炎 (AIH) 可能对标准治疗如塔克罗利斯 (TAC) 和甲酸莫菲蒂尔 (MMF) 不耐药.
- 探索替代疗法对于患有不受控制的AIH的患者至关重要.
- 环胺 (CYC) 在AIH中仅有有限的记录使用,主要是在病例报告中.
研究的目的:
- 审查自免疫性肝炎 (AIH) 患者中循环胺 (CYC) 治疗的疗效和安全性.
- 评估CYC作为耐火AIH或具有肝外自身免疫并发症的AIH的潜在治疗选择.
主要方法:
- 使用关键词"自身免疫性肝炎"和"cyclophosphamide"进行了系统的文献搜索.
- 分析了7项研究中的13名患者的数据,包括人口统计,实验室参数和组织学发现.
- 记录了患者关于缓解,安全和复发的结果.
主要成果:
- 环胺 (CYC) 用于13名患者,其中9人 (69.2%) 患有原发性耐火性AIH,4人 (30.8%) 需要作为同时存在的自身免疫性疾病的救援疗法.
- 在难以治疗的AIH患者中观察到总体缓解率为88.9% (8/9).
- 十二名患者 (92.3%) 对CYC有积极反应,在随访期间没有复发,表明可接受的安全性.
结论:
- 环胺 (CYC) 是一种潜在的替代性二线疗法,用于治疗自身免疫性肝炎 (AIH),当一线治疗失败时.
- 药物遗传学方法可能有助于指导个性化的CYC治疗.
- 需要进一步研究更大的样本大小来证实这些初步发现.
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