环磷酰胺治疗原发性硬化性胆管炎的疗效观察

目的 探讨环磷酰胺治疗原发性硬化性胆管炎（PSC）的临床疗效.方法 选择2004年1月-2012年12月在本院消化内科治疗的24例PSC患者作为观察对象,随机分为观察组13例和对照组11例,对照组常规应用熊去氧胆酸进行治疗,观察组应用熊去氧胆酸和环磷酰胺进行治疗,两组患者治疗4周后,比较两组患者的临床疗效、胆红素的变化及用药后的不良反应.计数资料采用Fisher确切概率法,计量资料采用独立样本的t检验和配对样本的t检验进行分析.结果 对照组的有效率为45.45%,观察组的有效率为84.62%,观察组明显高于对照组（P=0.0489）;观察组与对照组相比,治疗后TBil以及DBil改善明显,两组比较差异有统计学意义（t=12.45,P＜0.001;t=5.60,P＜0.001）.对照组治疗后的不良反应发生率为18.18%,观察组的不良反应发生率为23.08%,观察组的不良反应的发生率略高于对照组,差异无统计学意义（P=0.741）.结论 环磷酰胺治疗PSC临床疗效明显,不良反应的发生率在患者耐受范围内,故可在临床治疗中试用.

Clinical efficacy of cyclophosphamide in treatment of primary sclerosing cholangitis

Objective To investigate the clinical efficacy of cyclophosphamide in the treatment of primary sclerosing cholangitis （PSC）. Methods Twenty - four patients with PSC who received treatment in the department of gastroenterology in our hospital from January 2004 to December 2012 were selected as subjects and divided into observation group （n = 13 ） and control group （n = 11 ）. The control group was treated with ursodesoxycholic acid, while the observation group with ursodesoxycholic acid plus cyclophosphamide. After four weeks of treat- ment, clinical outcome, changes in serum bilirubin levels, and adverse reactions were compared between the two groups. Categorical data were analyzed by Fisher exact probability test, and continuous data by independent - samples t test and paired - samples t test. Results Compared with the control group, the observation group had a significantly higher response rate （ 84.62 % vs 45.45 %, P = 0. 0489 ） , signif- icantly more improvements in serum total and direct bilirubin levels （ t = 12.45, P 〈 0. 001 ; t = 5.60, P 〈 0.001 ）, and a nonsignificantly higher incidence of adverse reactions （23.08% vs 18.18%, P =0.741 ）. Conclusion Cyclophosphamide has significant clinical efficacy and tolerable incidence of adverse events in the treatment of PSC, so it is worthy of application in clinical treatment.