英夫利西单抗组合方案对广泛病变型克罗恩病患者的炎症指标和肠黏膜愈合的影响  

Effect of infliximab combination therapy on inflammatory biomarkers and intestinal mucosal healing in patients with extensive Crohn’s disease

作　　者：简嘉甫 刘思雪[1] 武晖博 钟娃[1] 夏忠胜[1] 钟英强[1] Jian Jiafu;Liu Sixue;Wu Huibo;Zhong Wa;Xia Zhongsheng;Zhong Yingqiang(Department of Gastroenterology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,China)

机构地区：[1]中山大学孙逸仙纪念医院消化内科,广州510120

出　　处：《新医学》2022年第3期208-213,共6页Journal of New Medicine

基　　金：中国医学奖励基金会(XHYSGZZSDX-001)。

摘　　要：目的观察英夫利西单抗(IFX)组合方案对广泛病变型克罗恩病(CD)患者的炎症指标及肠黏膜愈合的影响。方法采用中山大学孙逸仙纪念医院的内镜分级评价标准及肠黏膜愈合标准,回顾性分析160例广泛病变型CD患者[IFX组合方案治疗组(98例)、传统药物治疗组(62例)]的炎症指标及肠黏膜愈合资料。结果IFX组合方案治疗组在第2次治疗前,CRP、ESR、IL-6迅速下降,血清TNF-α升高(P均<0.05)。IFX组合方案治疗组中,治疗达12次患者的结肠黏膜愈合率与小于12次的患者比较差异有统计学意义(P<0.05)。IFX组合方案治疗组内镜下总有效率(80.3%,57/71)较传统药物治疗组(64.5%,40/62)患者高(P=0.041)。结论应用IFX组合方案可使患者血清TNF-α水平明显升高,但不影响肠黏膜的愈合。IFX组合方案较传统药物治疗组更可促进结肠黏膜愈合。Objective To investigate the effect of infliximab(IFX)combination therapy on inflammatory biomarkers and intestinal mucosal healing in patients with extensive Crohn’s disease(CD).Methods According to the evaluation criteria of endoscopic grading score and mucosal healing of Sun Yat-sen Memorial Hospital of Sun Yat-sen University,inflammatory biomarkers and mucosal healing data of 160 patients with extensive CD were retrospectively analyzed.All patients were assigned into the IFX combination therapy group(n=98)and conventional drug therapy group(n=62).Results The C-reactive protein(CRP)level,erythrocyte sedimentation rate(ESR)and interleukin 6(IL-6)level began to decline,but the serum TNF-αlevel increased during the second cycle of IFX treatment.In the IFX combination therapy group,the healing rate of colonic mucosa in patients treated for 12 times had statistical significance compared with that of those treated for less than 12 times(P<0.05).In the IFX combination therapy group,the endoscopic total effective rate was 80.3%(57/71),significantly higher than 64.5%(40/62)in the conventional drug therapy group(P=0.041).Conclusions IFX combination regimen can significantly increase the serum TNF-αlevel,whereas it exerts no effect upon intestinal mucosal healing.IFX combination therapy can more effectively promote colonic mucosal healing than conventional therapy.

关 键 词：炎症性肠病 克罗恩病 英夫利西单抗 黏膜愈合 炎症因子 

分 类 号：R574[医药卫生—消化系统]