胃と腸48巻5号

2013年05月発行

特集 炎症性腸疾患 2013 主題 炎症性腸疾患の治療

血球成分除去療法の適応と有効性

著者： 花井洋行¹ 飯田貴之¹ 池谷健太郎¹ 阿部仁郎¹ 天野友香理¹ 渡辺文利¹

所属機関： ¹浜松南病院　消化器病・IBDセンター

ページ範囲：P.681 - P.688

潰瘍性大腸炎（UC）とCrohn病（CD）の治療には種々の選択肢が存在する．重症例やステロイド依存性，抵抗性など難治性には血球成分除去療法（CAP），インフリキシマブ，タクロリムスなどがこの10年間に保険適用となった．そのなかでもCAPは安全に使用することが可能で，特に集中治療により重症例や難治性の患者に対してよい結果が報告されている．これまでのGMA，LCAP療法の結果から解析すると，よい反応を示す症例の特徴は，（1）初発症例，（2）ステロイド未使用例，（3）罹病期間が短いなどである．ステロイド使用以前にこの治療法が実施されることが望ましい．重篤な副作用が認められないだけに寛解導入療法としてCAP療法の果たす役割は大きい．

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