阿达木单抗治疗克罗恩病患者的临床疗效及预测因素分析  

Clinical efficacy and predictive factors of adalimumab in the treatment of Crohn's disease

作　　者：王芬 WANG Fen(Affiliated Hospital of Heze Medical College,Heze 274000,Shandong)

机构地区：[1]菏泽医学专科学校附属医院,山东菏泽274000

出　　处：《菏泽医学专科学校学报》2023年第3期41-44,78,共5页Journal of Heze Medical College

摘　　要：目的探究阿达木单抗(ADA)治疗克罗恩病(CD)患者的临床效果。方法选择2019年1月—2020年1月我院消化内科收治的80例CD患者,按照随机数字表法分为观察组和对照组,每组40例。对照组采用常规治疗,观察组在对照组的基础上加用ADA治疗,观察两组患者的治疗效果。结果治疗前两组患者除腹泻次数(P<0.05)外,腹痛程度评分、克罗恩病活动度评分(CDAI)比较,P均>0.05;治疗后观察组上述各项指标均低于对照组(P均<0.05)。两组治疗4周后诱导缓解比较,P<0.05,而在治疗12周后两组诱导缓解比较,P>0.05。两组治疗前降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、血管细胞粘附分子-1(VCAM-1)水平比较,P均>0.05,治疗后观察组PCT、TNF-α、IL-6、VCAM-1水平均低于对照组(P均<0.05)。两组治疗前免疫功能比较,P>0.05;观察组治疗后的辅助性T细胞(CD4^(+))、CD4^(+)/细胞毒性T细胞(CD8^(+))高于对照组,但+CD8低于对照组(P<0.05)。结论规范使用ADA有助于缓解患者的腹痛、腹泻,还能够调节炎症指标,有效提升机体免疫功能。Objective To explore the clinical effect of Adalimumab(ADA)on patients with Crohn's Disease(CD).Methods A total of 80 patients with CD who were treated in the Department of Gastroenterology of our hospital from January 2019 to January 2020 were randomly divided into the observation group and the control group,with 40 patients in each group.The patients in the control group were treated with conventional therapy,while the patients in the observation group were treated with ADA on the basis of the control group.The diagnosis and treatment effect of the two groups were observed.Results Before treatment,there was no significant difference in abdominal pain score and Crohn's disease activity index(CDAI)(P>0.05),except for the number of diarrhea(P<0.05)between the two groups.After treatment,the above indexes in the observation group were lower than those in the control group(P<0.05).4 weeks after treatment,the comparison of remission rate was with P<0.05 between the two groups,while 12 weeks after treatment,the comparison of remission rate was with P>0.05 between the two groups.Before treatment,there was no significant difference in the levels of procalcitonin(PCT),tumor necrosis factor(TNF-α),interleukin 6(IL-6)and vascular cell adhesion molecule 1(VCAM-1)between the two groups(P>0.05).After treatment,the levels of PCT,TNF-α,IL-6,and VCAM-1 in the observation were significantly lower than those in the control group(P<0.05).There was no significant difference in immune function between the two groups before treatment(P>0.05).After treatment,the auxiliary T cells(CD4^(+))and CD4^(+)/cytotoxic T cells(CD8^(+))in the observation+group were higher than those in the control group,but the CD8 was lower than that in the control group(P<0.05).Conclusion Standardized use of ADA can alleviate abdominal pain and redice diarrhea times,regulate inflammatory indicators,effectively improve the immune function of the body in the treatment of Crohn's disease.

关 键 词：克罗恩病 阿达木单抗治疗 人肿瘤坏死因子-Α 疗效 

分 类 号：R572.3[医药卫生—消化系统]