抗疟药物在系统性红斑狼疮中的临床应用
刘湘源, 黄烽
(中国人民解放军总医院风湿科,北京 100853)
[摘要] 简述了可用于治疗系统性红斑狼疮的三种抗疟药物(氯喹、羟氯喹和阿的平)的药代动力学、作用机制、临床应用及药物不良反应。抗疟药物通过抗炎、免疫抑制、光保护作用、抗血小板聚集及降低血脂等作用,主要应用于轻、中度脏器受累的系统性红斑狼疮,在改善病情、维持病情稳定及预防疾病复发中可发挥重要作用。该类药物安全有效、耐受性良好。
[关键词] 抗疟药; 系统性红斑狼疮; 临床应用
Clinical applications of antimalarial drugs in the management of systemic lupus erythematosus
LIU Xiang-yuan, Huang Feng
, 百拇医药
(Department of Rheumatology, General Hospital of PLA, Beijing 100853,China.)
[Abstract] Since 1950s, Antimalarial drugs (chloroquine, hydroxychloroquine, quinacrine) as slow-acting antirheumatic drugs have been used extensively in the treatment of systemic lupus erythematosus(SLE). Through the anti-inflammatory effects, immune inhibition, light filtration, antiplatelet aggregation and antihyperlipidemic actions, antimalarials are used in lupus primarily for the treatment of manifestations from mild to moderate organ involvement, and play important roles in preventing disease relapsing and exacerbation. It has been proved that antimalarials are effective and safe agents for the treatment of SLE with mild side effects. Pharmacokinetic feature, mechanism of action, clinical applications, adverse drug reactions are reviewed.
, 百拇医药
[Key words] antimalarial drugs; systemic lupus erythematosus; clinical applications
[作者简介] 刘湘源(1968-),男,副主任医师。主要从事类风湿关节炎及系统性红斑狼疮的研究;联系电话:(010)66936651,E-mail:liu-xiangyuan@263.net
[参 考文 献]
[1] Fox RI, Kang HI. Mechanism of action of antimalarial drugs: inhibition of antigen processing and presentation[J]. Lupus,1993,2 (Suppl 1): S9-12 .
[2] Goldman FD,Gilman AL,Hollenback C,et al. Hydroxychloroquine inhibits calcium signals in T cells: a new mechanism to explain its immunomodulatory properties[J]. Blood, 2000, 95(11): 3460-3466.
, 百拇医药
[3] Wallace DJ. Chloroquine and cytokines[J]. J Rheumatol,1997, 24(10): 2051-2052 .
[4] Wallace DJ. Antimalarial agents and lupus[J]. Rheum Dis Clin North Am,1994,20(1): 243-263
[5] Wallace DJ. Lupus, acquired immunodeficiency syndrome, and antimalarial agents[J]. Arthritis Rheum,1991,34(3): 372-373 .
[6] Johnson R,Loudon JR. Hydroxychloroquine sulfate prophylaxis for pulmonary embolism for patients with low friction arthroplasty[J] . Clin Orthop,1986,211:151-153.
, 百拇医药
[7] Wallace DJ, Linker-Israeli M, Metzger AL, et al. The relevance of antimalarial therapy with regard to thrombosis, hypercholesterolemia and cytokines in SLE[J]. Lupus,1993, 2(Suppl 1): S13-15 .
[8] Rahman P, Gladman DD, Urowitz MB, et al. The cholesterol lowering effect of antimalarial drugs is enhanced in patients with lupus taking corticosteroid drugs[J]. J Rheumatol, 1999 , 26(2): 325-330.
[9] The Canadian Hydroxychloroquine Study Group. A randomized study of the effect of withdrawing hydroxychloroquine sulfate in systemic lupus erythematosus[J]. N Eng J Med,1991,324:150-155.
, 百拇医药
[10] Toubi E,Rosner I,Rozenbaum M,et al. The benefit of combining hydroxychloroquine with quinacrine in the treatment of SLE patients[J] . Lupus, 2000, 9(2): 92-95.
[11] 杨岫岩,唐福林,尹培达.抗疟药的抗风湿作用.国外医学内科学分册,1997,24(7):277-280.
[12] Bernstein HN. Ophthalmologic considerations and testing in patients receiving long-term antimalarial therapy[J]. Am J Med,1983,75(suppl 1a):25-34.
[13] Easterbrook M. Ocular effects and safety of antimalarial agents[J]. Am J Med,1988,85(suppl 4a):1368-1373.
, 百拇医药
[14] Fries JF, Williams CA, Ramey D. The relative toxicity of disease-modifying antirheumatic drugs[J]. Arthritis Rheum,1993,36:297-301.
[15] Parke AL. Antimalarial drugs in pregnancy[J]. Scand J Rheumatol,1998,27(Suppl 107): 125-127.
[16] Jewell ML,McCauliffe DP. Patients with cutaneous lupus erythematosus who smoke are less responsive to antimalarial treatment[J]. J Am Acad Dermatol, 2000, 42(6):983-987., 百拇医药
(中国人民解放军总医院风湿科,北京 100853)
[摘要] 简述了可用于治疗系统性红斑狼疮的三种抗疟药物(氯喹、羟氯喹和阿的平)的药代动力学、作用机制、临床应用及药物不良反应。抗疟药物通过抗炎、免疫抑制、光保护作用、抗血小板聚集及降低血脂等作用,主要应用于轻、中度脏器受累的系统性红斑狼疮,在改善病情、维持病情稳定及预防疾病复发中可发挥重要作用。该类药物安全有效、耐受性良好。
[关键词] 抗疟药; 系统性红斑狼疮; 临床应用
Clinical applications of antimalarial drugs in the management of systemic lupus erythematosus
LIU Xiang-yuan, Huang Feng
, 百拇医药
(Department of Rheumatology, General Hospital of PLA, Beijing 100853,China.)
[Abstract] Since 1950s, Antimalarial drugs (chloroquine, hydroxychloroquine, quinacrine) as slow-acting antirheumatic drugs have been used extensively in the treatment of systemic lupus erythematosus(SLE). Through the anti-inflammatory effects, immune inhibition, light filtration, antiplatelet aggregation and antihyperlipidemic actions, antimalarials are used in lupus primarily for the treatment of manifestations from mild to moderate organ involvement, and play important roles in preventing disease relapsing and exacerbation. It has been proved that antimalarials are effective and safe agents for the treatment of SLE with mild side effects. Pharmacokinetic feature, mechanism of action, clinical applications, adverse drug reactions are reviewed.
, 百拇医药
[Key words] antimalarial drugs; systemic lupus erythematosus; clinical applications
[作者简介] 刘湘源(1968-),男,副主任医师。主要从事类风湿关节炎及系统性红斑狼疮的研究;联系电话:(010)66936651,E-mail:liu-xiangyuan@263.net
[参 考文 献]
[1] Fox RI, Kang HI. Mechanism of action of antimalarial drugs: inhibition of antigen processing and presentation[J]. Lupus,1993,2 (Suppl 1): S9-12 .
[2] Goldman FD,Gilman AL,Hollenback C,et al. Hydroxychloroquine inhibits calcium signals in T cells: a new mechanism to explain its immunomodulatory properties[J]. Blood, 2000, 95(11): 3460-3466.
, 百拇医药
[3] Wallace DJ. Chloroquine and cytokines[J]. J Rheumatol,1997, 24(10): 2051-2052 .
[4] Wallace DJ. Antimalarial agents and lupus[J]. Rheum Dis Clin North Am,1994,20(1): 243-263
[5] Wallace DJ. Lupus, acquired immunodeficiency syndrome, and antimalarial agents[J]. Arthritis Rheum,1991,34(3): 372-373 .
[6] Johnson R,Loudon JR. Hydroxychloroquine sulfate prophylaxis for pulmonary embolism for patients with low friction arthroplasty[J] . Clin Orthop,1986,211:151-153.
, 百拇医药
[7] Wallace DJ, Linker-Israeli M, Metzger AL, et al. The relevance of antimalarial therapy with regard to thrombosis, hypercholesterolemia and cytokines in SLE[J]. Lupus,1993, 2(Suppl 1): S13-15 .
[8] Rahman P, Gladman DD, Urowitz MB, et al. The cholesterol lowering effect of antimalarial drugs is enhanced in patients with lupus taking corticosteroid drugs[J]. J Rheumatol, 1999 , 26(2): 325-330.
[9] The Canadian Hydroxychloroquine Study Group. A randomized study of the effect of withdrawing hydroxychloroquine sulfate in systemic lupus erythematosus[J]. N Eng J Med,1991,324:150-155.
, 百拇医药
[10] Toubi E,Rosner I,Rozenbaum M,et al. The benefit of combining hydroxychloroquine with quinacrine in the treatment of SLE patients[J] . Lupus, 2000, 9(2): 92-95.
[11] 杨岫岩,唐福林,尹培达.抗疟药的抗风湿作用.国外医学内科学分册,1997,24(7):277-280.
[12] Bernstein HN. Ophthalmologic considerations and testing in patients receiving long-term antimalarial therapy[J]. Am J Med,1983,75(suppl 1a):25-34.
[13] Easterbrook M. Ocular effects and safety of antimalarial agents[J]. Am J Med,1988,85(suppl 4a):1368-1373.
, 百拇医药
[14] Fries JF, Williams CA, Ramey D. The relative toxicity of disease-modifying antirheumatic drugs[J]. Arthritis Rheum,1993,36:297-301.
[15] Parke AL. Antimalarial drugs in pregnancy[J]. Scand J Rheumatol,1998,27(Suppl 107): 125-127.
[16] Jewell ML,McCauliffe DP. Patients with cutaneous lupus erythematosus who smoke are less responsive to antimalarial treatment[J]. J Am Acad Dermatol, 2000, 42(6):983-987., 百拇医药