合并肠外表现的炎症性肠病患者英夫利西单抗治疗效果分析  

Analysis of Therapeutic Effect of Infliximab on Inflammatory Bowel Disease Patients Associated With Extra⁃intestinal Manifestations

作　　者：陈吟 梁丽娜[2] 熊永建 卢书明[2] CHEN Yin;LIANG Li’na;XIONG Yongjian;LU Shuming(Department of Gastroenterology,Guizhou Provincial People’s Hospital,Guiyang,550002;Department of Gastroenterology,the First Affiliated Hospital of Dalian Medical University,Dalian,Liaoning Province;Central Laboratory,the First Affiliated Hospital of Dalian Medical University,Dalian,Liaoning Province)

机构地区：[1]贵州省人民医院消化内科,550002 [2]大连医科大学附属第一医院消化内科 [3]大连医科大学附属第一医院中心实验室

出　　处：《胃肠病学》2022年第10期583-588,共6页Chinese Journal of Gastroenterology

基　　金：中国博士后科学基金面上资助(2020M670767)。

摘　　要：背景:炎症性肠病(IBD)发病率呈逐年升高的趋势,部分IBD患者合并肠外表现(EIM),且EIM对IBD治疗产生一定的影响。目的:总结合并EIM的IBD患者临床特征,并评价英夫利西单抗(IFX)的治疗效果。方法:回顾性分析2010年1月—2020年12月于大连医科大学附属第一医院诊断为IBD且同时合并EIM患者的临床资料,探讨IFX的治疗效果。结果:811例IBD患者中,50例(6.17%)合并EIM。EIM以关节炎(78.00%)、结节性红斑(26.00%)最为常见。52.00%的IBD患者合并1种EIM。合并EIM的UC患者中病变范围累及以E3最常见(68.42%),CD患者以L3最常见(50.00%)。共21例患者接受IFX治疗,用药后第2周HB、ALB明显上升,ESR、CRP、PLT明显下降;第22周83.33%的UC患者转为轻度,70.00%的CD患者进入缓解期。应用IFX后关节炎首次消失时间明显短于未应用IFX组(2.50 d对10.50 d,P<0.05)。CRP升高者关节炎首次消失中位时间亦明显短于CRP正常者(3.00 d对9.00 d,P<0.05)。结论:IBD患者合并EIM以关节炎、结节性红斑较为常见,应用IFX治疗可明显缩短部分EIM首次消失时间。Background:The incidence of inflammatory bowel disease(IBD)is increasing yearly,some of the IBD patients have extraintestinal manifestations(EIM),and EIM has impact on the treatment of IBD.Aims:To summarize the clinical characteristics of IBD patients associated with EIM,and evaluate the therapeutic effect of infliximab(IFX).Methods:The clinical data of IBD patients associated with EIM from January 2010 to December 2020 at the First Affiliated Hospital of Dalian Medical University were retrospectively analyzed,and the therapeutic effect of IFX was investigated.Results:In 811 patients with IBD,50(6.17%)patients had EIM.The commonly seen EIM was arthritis(78.00%)and erythema nodosum(26.00%);52.00%had one EIM;68.42%of UC patients with EIM involved E3,and 50.00%of CD patients with EIM involved L3.A total of 21 patients received IFX treatment,2 weeks after medication,HB and ALB significantly increased,while ESR,CRP and PLT significantly decreased.Twenty⁃two weeks after medication,83.33%of UC patients turned mild,and 70.00%of CD patients entered the remission phase.After the use of IFX,the first disappearance time of arthritis was significantly decreased when compared with those without using IFX(2.50 days vs.10.50 days,P<0.05).The median time for the first disappearance of arthritis in patients with elevated CRP was significantly decreased than in patients with normal CRP(3.00 days vs.9.00 days,P<0.05).Conclusions:Arthritis and erythema nodosum are common EMI in patients with IBD,and the treatment with IFX can significantly shorten the time of the first disappearance of some EIM.

关 键 词：炎症性肠病 肠外表现 关节炎 结节性红斑 英夫利西单抗 治疗 

分 类 号：R574[医药卫生—消化系统]