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干扰素α2a作为联合用药治疗难治性白塞病葡萄膜炎的疗效观察

莫静 王红 曹绪胜   

  1. 首都医科大学附属北京同仁医院 北京同仁眼科中心 眼科学与视觉科学北京市重点实验室100730
  • 收稿日期:2019-11-27 出版日期:2020-07-22 发布日期:2020-07-21
  • 通讯作者: 王红,Email:wanghongyk@sina.com
  • 基金资助:
    北京市自然科学基金(7122042)

Efficacy of interferon α2a as an add-on treatment for refractory Behcet’s uveitis

Mo Jing, Wang Hong, Cao Xusheng   

  1. Beijing Tongren Eye Center, Beijing Key Labaratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
  • Received:2019-11-27 Online:2020-07-22 Published:2020-07-21
  • Contact: Wang Hong, Email: wanghongyk@sina.com
  • Supported by:
    Natural Science Foundation of Beijing (7122042)

摘要: 目的 研究干扰素(Interferon,INF)α2a作为联合用药治疗难治性白塞病葡萄膜炎的有效性及安全性。设计 回顾性病例系列。研究对象 2016年11月至2019年12月北京同仁医院采用糖皮质激素激素联合免疫抑制剂后仍反复发作的难治性白塞病葡萄膜炎36例(70眼)。方法 回顾分析患者的门诊病历资料。所有患者联合IFNα2a皮下注射治疗。采用线性回归、Logistic回归及卡方检验分析联合治疗前后白塞病葡萄膜炎的复发频率(复发次数/年)、视力、糖皮质激素及免疫抑制剂用量的变化与患者性别、年龄、病程、免疫抑制剂种类、基线视力及随访时间的相关性。观察联合用药后的不良反应。主要指标 葡萄膜炎年复发频率、视力、糖皮质激素及免疫抑制剂用量变化及全身不良反应。结果 平均随访16.6±7.4(12~36)个月。100%的患者年复发频率从中位数7.5次/年(4~12次/年)降至0次/年(0~2次/年)(P=0.000)。线性回归分析显示年复发频率的减少与患者性别、年龄、病程、免疫抑制剂种类、基线视力及随访时间无关(P均>0.05)。25眼(35.7%)标准视力表视力提高≥2行,24眼(34.3%)视力不变,21眼(30%)视力下降≥2行。联合治疗前,所有患者糖皮质激素及免疫抑制剂不能减量。联合治疗后31例(86.1%)糖皮质激素减量,12例(32.9%)糖皮质激素减量至≤10 mg/天,2例(2.9%)停糖皮质激素。20例(55.6%)免疫抑制剂减量。Logistic回归分析和卡方检验显示视力变化、糖皮质激素减量和免疫抑制剂减量均与患者性别、年龄、病程、免疫抑制剂种类、基线视力及随访时间无关(P均>0.05)。随访过程中未出现严重的药物不良反应。结论 IFNα2a作为联合用药能安全有效地治疗难治性白塞病葡萄膜炎。(眼科,2020,29: 273-277)
      

关键词: 干扰素&alpha, 2a;白塞病葡萄膜炎

Abstract: Objective To estimate the efficacy and safety of Interferon (INF)α2a as an add-on treatment for refractory Behcet’s uveitis(BU). Design Retrospective case series. Participants 36 patients (70 eyes) with refractory BU who underwent relapse under corticosteroids and conventional immunosuppressive agents in Beijing Tongren Eye Center from November 2016 to December 2019 were included. Methods The outpatient medical records were reviewed. All patients took INFα2a as an add-on treatment. Linear regression, Logistic regression and Chi-square test were used to reveal the correlation between the change of frequency of relapse, vision, dosage of corticosteroids, dosage of immunosuppressive agents and gender, age, course of BU, immunosuppressive agents, baseline vision, follow- up duration. The side effects were monitored. Main Outcome Measures  Changes in ocular relapse frequency and vision acuity, changes of the dosage of corticosteroids and immunosuppressive agents, and side effects. Results During a mean follow-up of 16.6±7.4 (12~36) months, the median frequency of relapse decreased from 7.5 (range 4~12) per year to 0 (range 0~2) per year (P=0.000). Linear regression revealed no correlation between the decreased frequency of relapse and gender, age, course of BU, immunosuppressive agent, baseline vision, follow-up duration (P>0.05). Visual improvement was observed in 25 eyes (35.7%) ,visual stability was observed in 24 eyes (34.3%), and visual deterioration was observed in 21 eyes (30%). Corticosteroids were lowered in 31 patients (86.1%), the dosage were reduced to lower than 10mg/day in 12 patients (32.9%) , and completely withdrawn in 2 patients (2.9%). Immunosuppressive agents were reduced in 20 patients (55.6%). Logistic regression revealed no correlation between the change of vision, dosage of corticosteroids, dosage of immunosuppressive agents and gender, age, course of BU, immunosuppressive agent, baseline vision, follow-upduration (P>0.05). No severe adverse events were observed. Conclusion INFα2a is effective and safe for refractory BU as an add-on treatment. (Ophthalmol CHN, 2020, 29: 273-277)

Key words: interferon α2a, Behcet’s uveitis