抗肿瘤坏死因子-α诱导克罗恩病患者肠黏膜愈合情况的回顾性分析  

Retrospective Analysis of Intestinal Mucosal Healing in Patients with Crohn’s Disease Induced by Anti-tumor Necrosis Factor-α

作　　者：卢立男 刘丹[1] 刘冰熔[1] LU Linan;LIU Dan;LIU Bingrong(Department of Gastroenterology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院消化内科,河南郑州450000

出　　处：《河南医学研究》2022年第10期1746-1750,共5页Henan Medical Research

基　　金：中原英才计划(ZYYCYU202012113);河南省重点研发与推广专项项目(222102310038)。

摘　　要：目的探讨克罗恩病(CD)患者接受抗肿瘤坏死因子-α(TNF-α)治疗3个月及12个月时的回、结肠各节段黏膜病变愈合情况,以评估抗TNF-α治疗对不同部位肠道病变的疗效。方法回顾性收集2018年10月至2021年6月在郑州大学第一附属医院接受抗TNF-α治疗的34例中、重度CD患者,分析治疗前和治疗后3、12个月时患者炎症指标和回、结肠各肠段(末端回肠、升结肠、横结肠、降结肠和乙状结肠、直肠)的内镜下黏膜病变愈合情况。结果与治疗前相比,治疗3个月及12个月的炎症指标改善(P<0.05),治疗12个月时炎症指标较3个月时无变化(P>0.05);治疗3个月及12个月时升结肠及横结肠的内镜下黏膜愈合较治疗前改善(P<0.05);末端回肠、降结肠及乙状结肠和直肠内镜下黏膜愈合率较治疗前无改善(P>0.05)。结论回结肠不同肠段CD病变对抗TNF-α治疗的反应不同,结肠段总体黏膜愈合情况优于末端回肠,横结肠和升结肠的黏膜愈合率最高。Objective To investigate the healing of mucosal lesions in different segments of ileum and colon in patients with Crohn,s disease(CD)treated with anti-tumor necrosis factor-α(TNF-α)therapy for 3 months and 12 months,so as to evaluate the efficacy of anti-TNF-αtherapy in the treatment of intestinal lesions in different parts.Methods A total of 34 patients with moderate and severe CD who received anti-TNF-αtherapy in the first affiliated Hospital of Zhengzhou University from October 2018 to June 2021 were collected retrospectively.The inflammatory indexes and endoscopic mucosal healing of ileum and colon(terminal ileum,ascending colon,transverse colon,descending colon,sigmoid colon and rectum)were analyzed before treatment and 3 months and 12 months after treatment.Results Compared with those before treatment,the inflammatory indexes of 3 months and 12 months after treatment were improved(P<0.05),but there was no change after 12 months of treatment compared with 3 months(P>0.05).Endoscopic mucosal healing of ascending colon and transverse colon was improved after 3 months and 12 months of treatment(P<0.05).The mucosal healing rate of terminal ileum,descending colon and sigmoid colon,rectum under endoscopy was not improved as compared with that before treatment(P>0.05).Conclusion The response of CD lesions in different segments of ileocolon to anti-TNF-αtreatment is different.The overall mucosal healing of colon segment is better than that of terminal ileum,and the mucosal healing rate of transverse colon and ascending colon is the highest.

关 键 词：克罗恩病 抗肿瘤坏死因子-Α 黏膜愈合 

分 类 号：R574.6[医药卫生—消化系统]