英夫利昔单抗联合硫唑嘌呤治疗克罗恩病的临床疗效  

Clinical curative effects of infliximab combined with azathioprine on Crohn's disease

作　　者：陈兰[1] 文峰[2] 余卫中[1] 夏伶俐[1] 肖丹[1] 

机构地区：[1]江汉大学附属医院武汉市第六医院消化内科,武汉430015 [2]解放军161医院消化内科

出　　处：《西南国防医药》2016年第4期403-406,共4页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的研究英夫利昔单抗联合硫唑嘌呤治疗克罗恩病的临床疗效。方法临床入选180例中重度克罗恩病患者,随机分为硫唑嘌呤组、英夫利昔组及联合治疗组,每组60例,分别给予硫唑嘌呤、英夫利昔单抗及硫唑嘌呤联合英夫利昔单抗治疗。比较3组的疾病缓解率、黏膜愈合率以及治疗前后的ALB(血清白蛋白)、TLB(血清总蛋白)、WBC(白细胞)、CRP(C反应蛋白)及ESR(血沉)水平和不良反应情况。结果治疗第6 w时,3组疾病缓解率无统计学差异(P>0.05);治疗第10、18及26 w时,联合治疗组的疾病缓解率均较其他两组明显升高(P<0.05)。治疗第26 w时,硫唑嘌呤组黏膜愈合率为16.67%(10/60),英夫利昔组为28.33%(17/60),联合治疗组为51.67%(31/60),联合治疗组黏膜愈合率较其他两组明显升高(P<0.05)。治疗26 w后,3组的ALB、TLB水平均较治疗前明显升高,而WBC、CRP及ESR均较治疗前明显降低(P<0.05),且联合治疗组的上述指标改善幅度显著大于其他两组(P<0.05);3组的不良反应发生率无统计学差异(P>0.05),3组均未出现严重并发症。结论硫唑嘌呤联合英夫利昔单抗可以显著提高中重度克罗恩病患者的疾病缓解率和内镜下黏膜愈合率,同时具有较好的安全性,是克罗恩病较好的治疗方案。Objective To investigate the clinical curative effects of infliximab combined with azathioprine on Crohn＇s disease.Methods 180 patients with midrange or severe Crohn＇s disease were selected and randomly divided into azathioprine group,infliximab group, and combined treatment group with 60 cases in each group which received the treatment with azathioprine,infliximab, and the c ombination, respectively. Comparison was made in the remission rate of disease, the healing rate of mucous membrane, and ALB, TLB, WBC, CRP, and ESR before and after the treatment and the incidence of adverse reactions among the three groups. Results In the 6th week of the treatment, there was no significant difference in the remission rate among the three groups（P〈0.05）. In the 10 th, 18 th, and 26 th week of the treatment, the remission rate of the combination group significantly increased compared with those in the other two groups（P〈0.05）. In the 26 th week of the treatment, the healing rates of mucous membrane in the azathioprine, the infliximab group, and the combined treatment group were 16.67%（10/60）, 28.33%（17/60）, and 51.67%（31/60）,respectively. The healing rate of the combined treatment group increased significantly compared with those in the other two groups（P〈0.05）. In the 26 th week of the treatment, the ALB and TLB levels of the three groups increased significantly compared with those before the treatment, while the WBC, ESR, and CRP levels decreased significantly（P〈0.05）. The improvements of those indexes in the combined treatment group was larger than those in the other two groups（P〈0.05）. There was no significant difference in the incidence of adverse reactions among the three groups（P〈0.05）, and no serious complications occurred. Conclusion The combination of infliximab and azathioprine can significantly increase the remission rate and healing rate of mucous membrane in patients with midrange or severe Crohn＇s disease. At the same time, it has good safety and is an effe

关 键 词：克罗恩病 英夫利昔单抗 硫唑嘌呤 疗效 

分 类 号：R516.1[医药卫生—内科学]