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投稿时间：2018-03-10 网络发布日期：2018-09-20
投稿时间：2018-03-10 网络发布日期：2018-09-20
中文摘要: 目的 探讨英夫利昔单抗治疗炎症性肠病的临床疗效。方法 选择2013年2月至2016年9月河北省人民医院收治的30例克罗恩病患者为研究对象,随机分为观察组和对照组,每组15例。对照组给予英夫利昔单抗维持治疗,观察组使用英夫利昔单抗联合硫唑嘌呤的联合治疗方案。两组患者均于治疗前、治疗30周时,进行实验室指标检测［白细胞计数(WBC)、C反应蛋白(CRP)、血沉(ESR)、血红蛋白(HGB)、白蛋白(ALB)］及体质指数(BMI)测量,使用克罗恩病活动指数（CDAI）对病情进行评估,以CDAI<150分为缓解期,统计临床缓解率,采用克罗恩病简化内镜评分（SES-CD）对内镜下病变严重程度进行划分,统计黏膜愈合率、深度缓解率及不良反应发生情况。结果 两组治疗后WBC、CRP、ESR值均明显低于治疗前,HGB、ALB、BMI值均明显高于治疗前(P<0.01)。观察组治疗后CRP、ESR值明显低于对照组治疗后(P<0.01)。两组治疗后CDAI评分、SES-CD评分均明显低于治疗前,且两组的临床缓解率(86.67% vs 80.00%)、黏膜愈合率(60.00% vs 66.67%)、深度缓解率(66.76% vs 53.33%)、不良反应发生率(26.67% vs 20.00%)均相当（P>0.05）。结论 英夫利昔单抗单药治疗或联合免疫抑制剂均可有效控制克罗恩病患者的炎性反应活动,并有效维持临床缓解、黏膜愈合及深度缓解,具有较好的远期疗效。联合治疗方案在控制炎性反应方面具有更好的治疗效果。
中文关键词: 英夫利昔单抗 炎症性肠病 克罗恩病 免疫抑制剂；硫唑嘌呤
Abstract:Objective To investigate the clinical efficacy of infliximab in the treatment of inflammatory bowel disease(IBD). Methods Thirty patients with Crohn's disease treated from February 2013 to September 2016 were randomly divided into observation group and control group(n=15, each). Infliximab maintenance treatment was given in control group, and combined regimen of infliximab and azathioprine was given in observation group. Before and 30 weeks after treatment, laboratory indexes including white blood cell count (WBC), C reactive protein (CRP), erythrocyte sedimentation rate (ESR), hemoglobin (HGB), albumin (ALB) and body mass index (BMI) were measured; Crohn's disease activity index (CDAI) method was used to assess the disease, and remission was defined as a CDAI score <150; simplified endoscopic score for Crohn's disease (SES-CD) was used to classify the severity of lesions under endoscopy and to evaluate the mucosal healing rate; deep-remission rate and adverse reaction incidence were calculated. Results After treatment, the levels of WBC, CRP and ESR significantly decreased, and the values of HGB, ALB and BMI significantly increased compared with those before treatment in both two groups (all P<0.01), and the values of CRP and ESR in observation group were significantly lower than those in control group(P<0.01). After treatment, CDAI score and SES-CD score were significantly lower than those before treatment in both two groups, however, there were no statistical differences in clinical remission rate(86.67% vs 80.00%), mucosal healing rate(60.00% vs 66.67%), deep-remission rate (66.67% vs 53.33%)and adverse reaction rate (26.67% vs 20.00%)(P>0.05). Conclusion Both single-drug therapy of infliximab and combined therapy of infliximab and immune inhibitor can effectively control the inflammatory response activities, maintain valid clinical remission, mucosal healing and deep-remission and has a good long-term curative effect in patients with Crohn's disease. Combined therapy has a better therapeutic effect in controlling inflammatory response.
文章编号： 中图分类号：R 574.62 文献标志码：B
基金项目:河北省医学科学研究重点课题计划(20160067)
| Author Name | Affiliation |
| HU Yi-ting, SU Shao-hui, ZHANG Jian, JIA Gui-cong, HOU Hong-tao, BAI Yun, WANG Yu-zhen | Department of Gastroenterology, Hebei General Hospital, Shijiazhuang, Hebei 050051, China |
引用文本：
胡义亭,苏少慧,张建,贾桂丛,侯洪涛,白云,王玉珍.英夫利昔单抗治疗炎症性肠病30例临床分析[J].中国临床研究,2018,31(9):1253-1256.
胡义亭,苏少慧,张建,贾桂丛,侯洪涛,白云,王玉珍.英夫利昔单抗治疗炎症性肠病30例临床分析[J].中国临床研究,2018,31(9):1253-1256.