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題 名 | Methotrexate治療類固醇依賴型哮喘病人=Methotrexate in Steroid-Dependent Asthmatic Patients |
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作 者 | 吳莘華; 許正園; 黃枝梅; 江自得; | 書刊名 | 胸腔醫學 |
卷 期 | 14:3 1999.09[民88.09] |
頁 次 | 頁115-120 |
分類號 | 418.263 |
關鍵詞 | 類固醇依賴型哮喘; 類固醇節用藥物; Methotrexate; Steroid-sparing agent; Steroid-dependent asthma; |
語 文 | 中文(Chinese) |
中文摘要 | Methotrexate(MTX)是許多類固醇節用藥物(steroid-sparing agents)中的 一種。曾被用來治療類固醇依賴型哮喘(steroid-dependent asthma)病人,其真正機 轉並不十分清楚。本研究使用低劑量 MTX治療本國之類固醇依賴型哮喘病患, 希望藉此探討本國病人使用MTX後類固醇用量的改變情形,並進一步觀察MTX 對氣道內炎性反應的影響。研究之對象為類固醇依賴型慢性哮喘病患。共收集 16例病人。經過六個月MTX治療後,並無任何病人出現肝、腎功能或血液學方 面之異常。9例病人的口服類固醇得以減量,3例維持不變,4例必須增加劑量。 吸入型類固醇亦有9例可以減量,4例維持原劑量,3例必須加量。以痰液細胞 分類計數觀察發現,治療前後嗜伊紅性白血球的分類比率並無明顯改變。支氣管 纖維內視鏡黏膜活體生檢由於受檢人數太少,無法真正評斷MTX對支氣管黏膜 病理變化之影響。結論:對於某些類固醇依賴型哮喘病人,MTX確有不同程度的 類固醇節用效果,然並非每一個病人都有效。在安全累積劑量範圍內,可以謹慎 選擇病人使用。MTX的類固醇節用機轉仍然不明,但似乎不是經由抑制發炎細 胞而達成。其真正機轉,尚待進一步的研究證實。 |
英文摘要 | Treatment of 16 steroid-dependent asthmatic patients with methotrexate(MTX) 7.5mg/week was prospectively evaluated for 6 months. The doses of oral prednisolone were reduced in nine patients. Also, the doses of inhaled steroid were reduced in 9 of them. None was found to have significant hepatic, renal or hematologic abnormality. There is no marked sputum cellular characteristic change following the treatment. In conclusion, MTX may be useful as a steroid-sparing agent in some steroid- dependent asthmatic patients, but not all. Its use should be limited to selected patients under careful surveillance for response and possible toxicity. The mechanism of MTX's steroid-sparing effect has not been well elucidated yet. According to our data from limited cases underwent bronchoscopic mucosal biopsy , it seems inflammatory cell suppression is not an important mechanism. |
本系統中英文摘要資訊取自各篇刊載內容。