英夫利昔单抗与硫唑嘌呤联用治疗克罗恩病临床疗效观察  

Effect observation of infliximab combined with azathioprine on treatment of patients with Crohn′s disease

作　　者：王智云[1] 郑柳[1] 张明红[2] 

机构地区：[1]河北省唐山市人民医院药剂科,河北唐山063001 [2]河北省唐山市传染病医院药剂科,河北唐山063020

出　　处：《实用临床医药杂志》2014年第1期75-78,共4页Journal of Clinical Medicine in Practice

基　　金：中国高校医学期刊临床专项资金(11321491)

摘　　要：目的评价比较英夫利昔单抗单药治疗,硫唑嘌呤单药治疗或2者联合用药治疗克罗恩病(CD)疗效。方法 105例患者被随机分配成3组,每组35例。英夫利昔单抗组患者分别于第1天,第2周和第6周给予静脉输注英夫利昔单抗5mg/(kg·d);硫唑嘌呤组于0周,2周和6周口服硫唑嘌呤2.5mg/(kg·d);联合用药组为2种药物联合治疗。患者均接受30周药物治疗。观察各组临床缓解率和黏膜愈合效果。分析2组治疗前后血中白细胞计数(WBC)、血细胞沉降率(ESR)、C反应蛋白(CRP)、白蛋白(ALB)、血清总蛋白(TLB)水平变化情况。结果服用糖皮质激素后26周,联合用药组患者较英夫利昔组和硫唑嘌呤组临床缓解明显。在联合用药组严重感染率为2.9%,英夫利昔组5.7%和硫唑嘌呤组5.7%。与治疗前比较,各组治疗后WBC计数、ESR水平、CRP水平均明显降低,ALB、TLB水平均明显升高。联合用药组治疗后WBC计数、ESR水平、CRP水平明显低于其他2组,ALB、TLB水平明显高于其他2组。结论英夫利昔加硫唑嘌呤联合治疗中重度克罗恩病临床疗效明显。Objective To compare the clinical effects of single application of infliximab or azathioprineandcombinationofinfliximabandazathioprineonthe treatmentofpatientswithCrohn′ s disease（CD）. Methods 105 patients with CD were randomly divided into 3 groups, 35 cases in each group. Infliximab group was intravenously injected with 5 mg/（kg·d）infliximab at the time points of the first day, the second week and the sixth week respectively.Azathioprine group was orally taken with 2.5 mg/（kg·d）azathioprine at the time points of the first day, the second week and the sixth week respectively. Combination group was treated with infliximab and azathioprine.All the patients were treated for 30 weeks. Clinical remission rate and mucosal healing ability were observed in 3 groups, and the changes of white blood cell count（WBC）,erythrocyte sedimentation rate（ESR）, C reactive protein（CRP）, albumin（ALB）and total serum protein（TLB）levels before and after treatment were analyzed in all the groups. Results 26 weeks after administration of glucocorticoid,clinical remission rate in the combination group was higher than thatin the other two groups. The rates of severe infection were 2.9% in the combination group, 5.7% in the infliximab group and 5.7% in the azathioprine group. Post- therapeutic levels of WBC, ESR and CRP decreased significantly in all the groups, while ALB and TLB levels increased significantly. Levels of WBC, ESR and CRP in the combination group were significantly lower than those in the other twogroup, while the levels of ALB and TLB were significantly higher than the other two groups.Conclusion The combination of infliximab and azathioprine is proved to be an effective method for the treatment of moderate and severe CD.

关 键 词：克罗恩病 英夫利昔单抗 无糖皮质激素依赖的临床缓解率 黏膜愈合 

分 类 号：R574[医药卫生—消化系统]