英夫利昔单抗治疗克罗恩病第14周疗效评估及对于合并肛周病变患者的疗效比较  

Evaluation of efficacy of infliximab therapy in patients with crohn's disease at the 14th week and comparison of efficacy in patients with perianal lesions

作　　者：徐依人 沈卫东[1] 王文平 何晓伟[1] 周培[1] 刘兵团[1] XU Yiren;SHEN Weidong;WANG Wenping;HE Xiaowei;ZHOU Pei;LIU Bingtuan(Department of Gastroenterology,Jiangyin Hospital Affiliated to Southeast University School of Medicine,Jiangyin,Jiangsu,214400,China)

机构地区：[1]东南大学医学院附属江阴医院消化内科,江苏江阴214400

出　　处：《新疆医学》2025年第3期308-312,共5页Xinjiang Medical Journal

基　　金：徐州医科大学附属医院科技发展基金项目(项目编号:XYFC2020002);江苏省无锡市卫生健康委转化医学研究专项(项目编号:ZH202105);江苏省无锡市卫生健康委青年项目(项目编号:Q202155)。

摘　　要：目的评价克罗恩病(CD)患者首次使用英夫利西单抗(IFX)治疗第14周临床疗效,以及对于合并肛周病变患者的疗效比较。方法回顾性分析40例首次接受IFX治疗CD患者的临床资料,观察治疗前和治疗后第14周患者实验室指标、克罗恩病活动度指数(CDAI)、克罗恩病内镜评分(SES-CD)。后期按有无肛周病变进行分组,比较组间实验室指标及临床活动度改善情况。结果患者IFX治疗前SES-CD评分与BMI呈弱负相关,与有无其他治疗史呈弱正相关。与治疗前相比,治疗后第14周CD患者的血WBC、N、PLT、CRP、ESR、FC均下降(P<0.05),Hb、Alb、BMI均升高(P<0.05),CDAI评分与SES-CD评分较前降低(P<0.05)。IFX治疗后肛周病变组Hb、Alb差值较对照组升高(P<0.05),临床缓解率为22.2%,有效率为72.2%,优于对照组(缓解率:59.1%;有效率:31.8%)(P<0.05)。结论CD患者BMI、用药史与内镜下黏膜病变严重程度相关。IFX可以有效诱导CD患者实现临床缓解和黏膜愈合,且对于合并肛周病变患者在改善贫血、营养状况、临床活动度上疗效更为显著。Objective This study aimed to assess the efficacy of infliximab(IFX)treatment in patients with Crohn's disease(CD)at the 14th week and compare the efficacy between patients with and without perianal disease.Methods Clinical data of 40 patients with CD who received IFX for the first time were retrospectively analyzed,and laboratory indicators,Crohn's disease activity index(CDAI),Crohn's disease endoscopic score(SES-CD)were observed before treatment and 14 weeks after treatment.Patients were divided into groups based on the presence or absence of perianal lesions,and the improvement of laboratory indicators and clinical activity between the groups was compared.Results The SES-CD score of patients before IFX treatment negatively correlated with BMI and positively correlated with medication history,though both correlations were weak.After 14 weeks of IFX treatment,WBC,N,PLT,CRP,ESR,FC,CDAI score and SES-CD score showed significant reduction(P<0.05)in all 40 CD patients,while Hb,Alb and BMI increased(p<0.05).After IFX treatment,the perianal lesions group exhibited a higher difference in Hb and Alb compared to the non-perianal lesions group(P<0.05).The clinical remission rate was 22.2%,and the effective rate was 72.2%in the perianal lesions group,which was remarkably better than the non-perianal lesions group(clinical remission rate:59.1%;effective rate:31.8%;P<0.05).Conclusion BMI and medication history are associated with the severity of intestinal mucosal lesions in CD patients.IFX treatment effectively induces remission of active CD,promotes mucosal healing,and demonstrates greater effectiveness in improving anemia,nutritional status,and clinical remission in CD patients with perianal disease.

关 键 词：克罗恩病 英夫利昔 BMI 肛周病变 

分 类 号：R574[医药卫生—消化系统]