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硫唑嘌呤是治疗慢性活动性Crohn病(CD)的一种有效药物,但对少数病人作用有限或有副作用。霉酚酸莫非替克(mycophenolate mofetil,MMF)是霉酚酸的酯质前体,可抑制一磷酸肌苷脱氢酶并强力抑制淋巴细胞增生。它比甲氨喋呤更有效地减少由T细胞产生的γ-干扰素,MMF用于器官移植可防止移植体排斥。各种临床研究显示,它能抑制自身免疫性疾病和慢性炎症性疾病。此研究目的是比较硫唑嘌呤和MMF分别与皮质类固醇合用治疗慢性活动性CD的作用和副作用。
Azathioprine is a potent drug for the treatment of chronic active Crohn’s disease (CD) but has limited or adverse effects on a small number of patients. Mycophenolate mofetil (MMF), an ester precursor of mycophenolic acid, inhibits inosine monophosphate dehydrogenase and strongly inhibits lymphoproliferation. It is more effective than methotrexate to reduce the production of γ-interferon by T cells, and the use of MMF for organ transplantation prevents graft rejection. Various clinical studies have shown that it can inhibit autoimmune diseases and chronic inflammatory diseases. The aim of this study was to compare the effects and side effects of azathioprine and MMF with corticosteroids in the treatment of chronic active CD.