英夫利昔单抗治疗中重度溃疡性结肠炎的疗效观察
摘要
目的观察英夫利昔单抗(IFX)治疗中重度溃疡性结肠炎(UC)的疗效及药物安全性。方法收集2009年1月至2016年12月中国医科大学附属盛京医院第二消化内科病房收治的中重度UC患者(定义为基线期Mayo评分6～12分)92例,对其临床资料进行回顾性分析。结果 92例患者经IFX治疗,第14周临床有效率为85. 9%,缓解率为73. 9%,黏膜愈合率为44. 6%;第30周临床有效率为94. 6%,缓解率为86. 9%,黏膜愈合率为71. 7%。经IFX治疗第14周与第30周Mayo评分、Mayo内镜亚评分与治疗前相比,差异均有统计学意义(P <0. 05)。治疗第2、6、8、14、30周时WBC、PLT、Hb、ESR、CRP、PT、D-dimer、ALB分别与治疗前相比,差异有统计学意义(P <0. 01)。治疗期间未发生严重不良后果。完成30周英夫利昔单抗治疗的92例中重度溃疡性结肠炎患者中,2例患者因黏液脓血便持续发作,最终择期行回肠J型贮袋肛管吻合术(IPAA),另3例患者治疗过程中临床症状反复发作,进而应用环孢素转换治疗。结论 IFX可有效改善中重度UC患者的临床症状,降低炎症反应,促进肠黏膜愈合,且安全性较高。
引文
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[3]炎症性肠病诊断与治疗的共识意见(2012年·广州)[J].胃肠病学,2012,17(12):763-781.
[4]Mosli MH,Feagan BG,Sandborn WJ,et al.Histologic evaluation of ulcerative colitis:a systematic review of disease activity indices[J].Inflamm Bowel Dis,2014,20(3):564-575.DOI:10.1097/01.MIB.0000437986.00190.71.
[5]Meier J,Sturm A.Current treatment of ulcerative colitis[J].World J Gastroenterol,2011,17(27):3204-3212.DOI:10.3748/wjg.v17.i27.3204.
[6]田玲玲,刘丽娜.284例溃疡性结肠炎患者临床疗效分析[J].大连医科大学学报,2015,37(5):484-487.DOI:10.11724/jdmu.2015.05.17.
[7]江学良,星华.英夫利昔单抗治疗溃疡性结肠炎研究进展[J/CD].中华消化病与影像杂志:电子版,2012,2(5):349-351.DOI:10.3877/cma.j.issn.2095-2015.2012.05.014.
[8]Rutgeerts P,Sandborn WJ,Feagan BG,et al.Infliximab for induction and maintenance therapy for ulcerative colitis[J].N Engl J Med,2005,353(23):2462-2476.DOI:10.1056/NEJ-Moa050516.
[9]刘莉岚.英夫利昔治疗难治性中重度溃疡性结肠炎的效果分析[J].中外医学研究,2013,11(14):18.DOI:10.3969/j.issn.1674-6805.2013.14.013.
[10]Oztürk ZA,Dag MS,Kuyumcu ME,et al.Could platelet indices be new biomarkers for inflammatory bowel diseases?[J].Eur Rev Med Pharmacol Sci,2013,17(3):334-341.
[11]Zubcevic N,Mesihovic R,Zubcevic S.Usefulness of laboratory data in estimation of Crohn's disease activity[J].Med Arh,2010,64(1):33-36.
[12]陈白莉,钱家鸣,吴开春,等.英夫利西治疗活动性溃疡性结肠炎疗效与安全性的临床研究[J].中华炎性肠病杂志:中英文,2017,1(1):20-23.DOI:10.3760/cma.j.issn.2096-367X.2017.01.006.
[13]Chaparro M,Burgue1o P,Iglesias E,et al.Infliximab salvage therapy after failure of ciclosporin in corticosteroid-refractory ulcerative colitis:a multicentre study[J].Aliment Pharmacol Ther,2012,35(2):275-283.DOI:10.1111/j.1365-2036.2011.04934.x.
[14]Farkas K,Rutka M,Golovics PA,et al.Efficacy of Infliximab Biosimilar CT-P13 Induction Therapy on Mucosal Healing in Ulcerative Colitis[J].J Crohns Colitis,2016,10(11):1273-1278.DOI:10.1093/ecco-jcc/jjw085.
[15]王诗怡,范一宏,吕宾.炎症性肠病生物治疗的不良反应及防治策略[J].胃肠病学和肝病学杂志,2015,24(8):1006-1011.DOI:10.3969/j.issn.1006-5709.2015.08.030.