口腔医学研究

口腔医学研究 ›› 2017, Vol. 33 ›› Issue (1): 47-50.DOI: 10.13701/j.cnki.kqyxyj.2017.01.011

• 临床研究论著 • 上一篇    下一篇

小剂量短疗程泼尼松治疗顽固性复发性阿弗他溃疡的疗效及免疫改变

阮欢欢1,王文梅1*,王翔1,段宁1,蒋红柳1,白杨1,黎景景1,钱雅洁2,周倩2   

  1. 1. 南京大学医学院附属口腔医院·南京市口腔医院口腔黏膜病科 江苏 南京 210008;
    2. 南京大学医学院附属口腔医院·南京市口腔医院牙体牙髓病科 江苏 南京 210008
  • 收稿日期:2016-08-26 出版日期:2017-01-25 发布日期:2017-01-22
  • 通讯作者: 王文梅,电话:025—83620103
  • 作者简介:阮欢欢(1990~ ),女,安徽人,硕士在读,主要从事口腔黏膜疾病的临床和基础研究工作。
  • 基金资助:
    国家自然科学基金项目(编号:81570978,81400521)
    江苏省临床医学科技专项(编号:BL2014018)
    南京市科技计划项目(编号:201402033)

Effects of Prednisone on Clinical Outcome and Immune Parameters in the Treatment of Refractory Recurrent Aphthous Ulcer

RUAN Huan-huan1, WANG Wen-mei1*, WANG Xiang1, DUAN Ning1, JIANG Hong-liu1, BAI Yang1, LI Jing-jing1, QIAN Ya - jie2, ZHOU Qian2   

  1. 1. Department of Oral Membrane Disease,Nanjing Stomatological Hospital,Medical School of Nanjing University,Nanjing 210008,China;
    2. Department of Endodontics,Nanjing Stomatological Hospital,Medical School of Nanjing University,Nanjing 210008,China.
  • Received:2016-08-26 Online:2017-01-25 Published:2017-01-22

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摘要： 目的:探讨小剂量短疗程泼尼松治疗顽固性复发性阿弗他溃疡(顽固性RAU)的临床疗效及对免疫指标调节的作用。方法:选择37例顽固性RAU的患者,小剂量短疗程口服泼尼松治疗1个月,前20 d 10 mg/d,之后5 d减量为7.5 mg/d,最后5 d减量为5 mg/d,治疗前后检查血常规、肝肾功能、外周血体液和细胞相关免疫指标,观察治疗1个月、停药2个月后临床疗效及不良反应,治疗1个月后免疫指标改变。结果:小剂量短疗程口服泼尼松治疗顽固性RAU的治疗1个月后总有效率为100%,停药2个月后总有效率为91.4%,治疗1个月后外周血免疫球蛋白及补体(IgG、IgA、IgM、IgE和C4)水平降低(P<0.05),免疫细胞(B、T淋巴细胞及NK细胞)比例未出现明显差异。结论:采用小剂量短疗程泼尼松治疗顽固性RAU有较好的疗效,可延长溃疡发作间歇期,降低溃疡发作的数目、面积及疼痛程度,未见不良反应的发生。调节体液免疫可能是泼尼松治疗顽固性RAU的途径之一。

关键词: 顽固性复发性阿弗他溃疡, 泼尼松, 体液免疫, 细胞免疫

Abstract: Objective: To investigate the effects of low-dose and short-course oral prednisone on clinical outcome and immune parameters adjustment in the treatment of refractory recurrent aphthous ulcer (refractory RAU). Methods: Thirty-seven cases of patients with refractory RAU were administered with low-dose oral prednisone for one month. Ten mg/d prednisone for 20 days was then reduced to 7.5 mg/d for 5 days, and subsequently reduced to 5 mg/d for the last 5 days. Before and after treatment, blood routine, liver and kidney function, humoral and cellular immunity-related parameters in peripheral blood were tested. The clinical outcome and adverse reactions were evaluated after the treatment and two months later. Immune parameters change was observed after treatment. Results: The total efficiency was 100% after the treatment, and 91.4% at two months after the treatment. The levels of immunoglobulins and complements (IgG, IgA, IgM, IgE and C4) in peripheral blood significantly altered after the treatment (P<0.05). The percentages of immune cells (B and T lymphocytes and NK cells) in peripheral blood did not significantly change after the treatment. Conclusion: Low-dose and short-course oral prednisone therapy is effective in the treatment of refractory RAU with on adverse reaction, through prolonging intermission, reducing numbers and sizes of ulcers and decreasing pain index. The adjustment of humoral immunity could be one of the ways to treat refractory RAU.

Key words: Refractory, recurrent, aphthous, ulcer
Prednisone, Humoral, immunity, Cellular, immunity

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