临床意义的咪唑硫嘌呤在炎症性肠病活性代谢物浓度。
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赖特,桑德斯DS, Lobo AJ,林纳德L
临床意义的咪唑硫嘌呤在炎症性肠病活性代谢物浓度。
肠道。2004年8月,53 (8):1123 - 8。doi: 10.1136 / gut.2003.032896。
- PubMed ID
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15247179 (在PubMed]
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背景和目的:咪唑硫嘌呤的角色上有冲突的报道(阿扎)硫鸟嘌呤核苷酸(TGN)代谢产物在优化治疗炎症性肠病(IBD)。本研究的目的是调查TGN intrapatient变异,TGN浓度之间的关系和IBD患者的疾病活动长期持续服用,阿扎。方法:TGN和methylmercaptopurine核苷酸(MeMPN)浓度测定每隔两年时间。疾病活动是在每个诊所访问使用评估克罗恩病活动指数或Walmsley简单指数对溃疡性结肠炎。结果:串行TGN测量159例(3 - 14 TGN化验、中值6)。Intrapatient TGN浓度的变化是1-5-fold(平均1.6);违规行为的发生率为13%。最后的两年里,131名患者在TGN可评价的稳定状态。这一组,患者处于缓解期意味着TGN浓度明显高于发达活动性疾病患者(分别平均TGN 236 v 175;中位数差异44 pmol(95%置信区间1 - 92);p = 0.04)。 MeMPN concentrations were not related to AZA efficacy or toxicity. CONCLUSIONS: This study has shown that lower TGN concentrations were linked to the development of active disease, and that TGNs may act as useful markers of compliance. However, it is clear that repeat TGN measurements are required for an unambiguous index of active metabolite exposure. In view of the high intrapatient variability in TGN production over time, TGN measurements may not be currently advocated for routine clinical use.
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