维得利珠单克隆抗体治疗活动性溃疡性结肠炎的短期疗效分析:一项单中心回顾性观察性研究  

Short term efficacy of Vedolizumab in treating active ulcerative colitis:a single center retrospective observational study

作　　者：戴张晗[1] 陆君涛 王天蓉[1] 孙颖[1] 徐锡涛[1] 朱明明[1] 童锦禄[1] 冉志华[1] 俞文梅 乔宇琪[1] DAI Zhanghan;LU Juntao;WANG Tianrong;SUN Ying;XU Xitao;ZHU Mingming;TONG Jinlu;RAN Zhihua;YU Wenmei;QIAO Yuqi(Depatment of Gastroenterology and Hepatology,Renji Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200127;Depatment of Endocrinology,Shanghai Anda Hospital,China)

机构地区：[1]上海交通大学医学院附属仁济医院消化科,上海200127 [2]上海安达医院内分泌科

出　　处：《胃肠病学和肝病学杂志》2023年第10期1118-1121,共4页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的评估维得利珠单克隆抗体(Vedolizumab,VDZ)治疗活动性溃疡性结肠炎(ulcerative colitis,UC)的短期疗效。方法回顾性收集2020年11月至2022年2月上海交通大学医学院附属仁济医院消化科收治的使用VDZ诱导治疗的活动性UC患者的临床资料。分别采用改良Mayo评分和内镜Mayo评分(Mayo endoscopy score,MES)评估患者疾病活动度,分析VDZ治疗后第6周和第22/30周的临床和内镜缓解率,并比较分析第0周和第22/30周的白蛋白、血红蛋白、CRP、ESR和粪钙卫蛋白的差异。结果共纳入39例UC患者,41.0%患者既往使用生物制剂治疗失败。VDZ诱导治疗6周时,69.2%(27/39)患者达到临床缓解,82.1%(32/39)的患者有临床应答。第30周时,76.9%(30/39)的患者达到临床缓解,84.6%(33/39)的患者有临床应答。第22/30周内镜下黏膜愈合率为50.0%(16/32)。随访至30周时,7例(17.9%)患者停用VDZ治疗,其中4例因治疗无效且疾病加重行全结肠切除术。5例(12.8%)患者对VDZ部分应答者给予VDZ缩短疗程和/或联合用药,均获得临床缓解。第22/30周内镜MES评分较第0周显著下降(P<0.05)。第22/30周时粪钙卫蛋白和ESR较第0周明显下降(P<0.05)。随访中未出现严重感染、过敏及新发肿瘤等情况。结论VDZ短期内可安全有效地改善并维持UC患者的临床症状和内镜下表现。Objective To evaluate the effectiveness of Vedolizumab(VDZ)in treating active ulcerative colitis(UC)in short term.Methods Active UC patients who were hospitalized in the Department of Gastroenterology and Hepatology,Renji Hospital,School of Medicine,Shanghai Jiao Tong University,from Nov.2020 to Feb.2022 were included in this study.Clinical disease activity and endoscopy activity were evaluated by Mayo score and Mayo endoscopy score(MES)respectively.ALB,HGB,CRP,ESR and fecal calprotein were compared before and after the treatment.Results A total of 39 active UC patients were enrolled in the study(41.0%prior biologics failed).At week 6 of VDZ induction,clinical remission and response were achieved in 69.2%(27/39)and 82.1%(32/39)of patients,respectively.At week 30,76.9%(30/39)and 84.6%(33/39)of patients achieved clinical remission and clinical response.At week 22/30,50.0%(16/32)patients achieved mucosal healing.VDZ discontinuation prior to the 30 week was observed in 7 patients(17.9%).Due to aggravation of the disease in response to treatment,4 patients received total aolectomy.Five patients(12.8%)who were partially responded to VDZ achieved clinical remission after shorten the treatment interval or combination therapy.Compared to week 0,the MES score significantly decreased at week 22/30(P<0.05).The fecal calprotein and ESR reduced dramatically at week 22/30(P<0.05).No severe infection,allergic reaction or tumor were observed during the treatment.Conclusion VDZ safely induced clinical and endoscopic remission in active UC patients.

关 键 词：维得利珠单克隆抗体 溃疡性结肠炎 临床缓解 黏膜愈合 

分 类 号：R574.62[医药卫生—消化系统]