英夫利西单抗治疗小肠克罗恩病患者临床疗效观察及对患者黏膜愈合和血清实验指标影响
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摘要
[目的]探讨英夫利西单抗治疗小肠克罗恩病患者临床疗效观察及对患者黏膜愈合和血清实验指标影响。[方法]选自我院于2014年3月~2017年3月收治的小肠克罗恩病患者94例,按照随机表法分为观察组47例与对照组47例。对照组口服硫唑嘌呤片,观察组在对照组基础上结合注射用英夫利西单抗。2组均以8周为1个周期,疗程均为4个周期。比较2组治疗疗效,治疗前后CDEIS评分、主观症状评分、CDAI评分、血清实验指标变化和黏膜愈合情况。[结果]观察组总有效率(82.98%)高于对照组(59.57%)(P<0.05)。2组治疗后CDEIS评分、主观症状评分及CDAI评分降低(观察组:t=23.7080、22.5599、22.7149,对照组:t=15.5055、10.0715、13.2485,P<0.05);观察组治疗后CDEIS评分、主观症状评分及CDAI评分高于对照组(t=10.8065、13.9072、10.0482,P<0.05)。2组治疗后CRP和ESR降低而TLB和ALB增加(观察组:t=30.0790、21.4127、19.8374、22.7012,对照组:t=24.7104、8.6120、12.9603、12.9035,P<0.05);观察组治疗后CRP和ESR低于对照组而TLB和ALB高于对照组(t=21.7920、11.5971、7.8347、13.0521,P<0.05)。观察组黏膜愈合率(51.06%)高于对照组(29.79%)(P<0.05)。[结论]英夫利西单抗治疗小肠克罗恩病患者临床疗效明显,可改善患者黏膜愈合,增加TLB和ALB及降低CRP和ESR,具有重要研究意义。
[Objective]To discuss the clinical efficacy of infliximab treatment on patients with small bowel Crohn's disease,and its effects on mucosal healing and blood-serum experiment index.[Methods]94 patients with small bowel Crohn's disease in our hospital from March 2014 to March 2017 were divided into the observation group(47 cases)and the control group(47 cases)according to the random number table.The control group was treated with Azathioprine tablets,while the observation group was combined Azathioprine tablets with Infliximab.The 8 weeks meant 1 cycle,and the whole treatment period included 4 cycles in the both two groups.The therapeutic effect,the CDEIS score,the subjective symptom score,the CDAI score,the blood-serum experiment index,and the healing rate of the mucosal were all compared between the two groups before and after treatments.[Results]The total effective rate of the observation group(82.98%)was higher than that of the control group(59.57%)(P<0.05).In the both two groups,the scores of CDEIS,the subjective symptom score and the CDAI score were all reduced after treatment(theobservation group:t=23.7080,22.5599,22.7149,and the control group:t=15.5055,10.0715,13.2485,P<0.05).The decrease of CRP and ESR,and the increase of TLB and ALB were all observed after treatment in the 2 groups(observation group:t=30.0790,21.4127,19.8374,22.7012,t=24.7104,8.6120,12.9603,12.9035,P<0.05).After treatment,the CRP and ESR in the observation group were lower than those in the control group,while the TLB and ALB were higher than those in the control group(t=21.7920,11.5971,7.8347,13.0521,P <0.05).The healing rate of mucosal in the observation group(51.06%)was higher than that in the control group(29.79%)(P<0.05).[Conclusion]The infliximab has obvious clinical efficacy in the treatment on patients with small bowel Crohn's disease,and can improve the mucosal healing,increase the TLB and ALB,and reduce the CRP and ESR,which means important research significance.
[Objective]To discuss the clinical efficacy of infliximab treatment on patients with small bowel Crohn's disease,and its effects on mucosal healing and blood-serum experiment index.[Methods]94 patients with small bowel Crohn's disease in our hospital from March 2014 to March 2017 were divided into the observation group(47 cases)and the control group(47 cases)according to the random number table.The control group was treated with Azathioprine tablets,while the observation group was combined Azathioprine tablets with Infliximab.The 8 weeks meant 1 cycle,and the whole treatment period included 4 cycles in the both two groups.The therapeutic effect,the CDEIS score,the subjective symptom score,the CDAI score,the blood-serum experiment index,and the healing rate of the mucosal were all compared between the two groups before and after treatments.[Results]The total effective rate of the observation group(82.98%)was higher than that of the control group(59.57%)(P<0.05).In the both two groups,the scores of CDEIS,the subjective symptom score and the CDAI score were all reduced after treatment(theobservation group:t=23.7080,22.5599,22.7149,and the control group:t=15.5055,10.0715,13.2485,P<0.05).The decrease of CRP and ESR,and the increase of TLB and ALB were all observed after treatment in the 2 groups(observation group:t=30.0790,21.4127,19.8374,22.7012,t=24.7104,8.6120,12.9603,12.9035,P<0.05).After treatment,the CRP and ESR in the observation group were lower than those in the control group,while the TLB and ALB were higher than those in the control group(t=21.7920,11.5971,7.8347,13.0521,P <0.05).The healing rate of mucosal in the observation group(51.06%)was higher than that in the control group(29.79%)(P<0.05).[Conclusion]The infliximab has obvious clinical efficacy in the treatment on patients with small bowel Crohn's disease,and can improve the mucosal healing,increase the TLB and ALB,and reduce the CRP and ESR,which means important research significance.
引文
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[5]邱琛,朱振浩,龚伟,等.胶囊内镜在小肠克罗恩病英夫利西单抗治疗第14周疗效评估中的应用价值[J].中华消化内镜杂志,2017,34(3):181-185.
[6]中华医学会消化病学分会炎症性肠病协作组.中国炎症性肠病诊断治疗规范的共识意见[J].中华消化杂志,2008,47(1):73-79.
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[8]Stüber E,Büschenfeld A,Lüttges J,et al.The expression of OX40in immunologically mediated diseases of the gastrointestinal tract(celiac disease,Crohn’s disease,ulcerative colitis)[J].Eur J Clin Invest,2015,30(7):594-599.
[9]Sands B E,Sandborn W J,Van A G,et al.Vedolizumab as induction and maintenance therapy for Crohn’s disease in patients na6ve to or who have failed tumor necrosis factor antagonist therapy[J].Inflammatory Bowel Diseases,2017,23(1):97-97.
[10]Feagan B G.Review article:economic issues in Crohn’s disease--assessing the effects of new treatments on health-related quality of life[J].Aliment Pharmacol Ther,2015,13(4):29-37.
[11]朱振浩,邱琛,张明,等.英夫利西单抗治疗的小肠克罗恩病患者不同肠段黏膜愈合情况分析[J].南方医科大学学报,2017,37(1):44-48.
[12]陈禾凤,陈冰,杨婉花.克罗恩病治疗中英夫利西单抗药物监测的临床意义[J].中国医院药学杂志,2016,36(22):2030-2034.
[13]廖诗乐,陈白莉,胡坤华,等.英夫利西单抗治疗克罗恩病黏膜愈合的血清差异蛋白质表达研究[J].中国病理生理杂志,2015,31(5):894-899.
[14]卜亚洲.英夫利西单抗辅助治疗克罗恩病伴不全性肠梗阻患者的疗效及安全性分析[J].中国卫生标准管理,2016,7(6):88-89.
[2]Büning C,Genschel J,Bühner S,et al.Mutations in the NOD2/CARD15gene in Crohn’s disease are associated with ileocecal resection and are a risk factor for reoperation[J].Alimentary Pharmacology&Therapeutics,2015,19(10):1073-1078.
[3]Benami H,Ginesin Y,Behar D M,et al.Diagnosis and treatment of urinary tract complications in Crohn’s disease:an experience over 15years[J].Cana J Gastroenterol,2016,16(16):225-229.
[4]Cui B,Feng Q,Wang H,et al.Fecal microbiota transplantation through mid-gut for refractory Crohn’s disease:Safety,feasibility and efficacy trial results[J].J Gastroenterol&Hepatol,2015,30(1):51-51.
[5]邱琛,朱振浩,龚伟,等.胶囊内镜在小肠克罗恩病英夫利西单抗治疗第14周疗效评估中的应用价值[J].中华消化内镜杂志,2017,34(3):181-185.
[6]中华医学会消化病学分会炎症性肠病协作组.中国炎症性肠病诊断治疗规范的共识意见[J].中华消化杂志,2008,47(1):73-79.
[7]Schaubeck M,Clavel T,Calasan J,et al.Dysbiotic gut microbiota causes transmissible Crohn’s disease-like ileitis independent of failure in antimicrobial defence[J].Gut,2016,65(2):225-225.
[8]Stüber E,Büschenfeld A,Lüttges J,et al.The expression of OX40in immunologically mediated diseases of the gastrointestinal tract(celiac disease,Crohn’s disease,ulcerative colitis)[J].Eur J Clin Invest,2015,30(7):594-599.
[9]Sands B E,Sandborn W J,Van A G,et al.Vedolizumab as induction and maintenance therapy for Crohn’s disease in patients na6ve to or who have failed tumor necrosis factor antagonist therapy[J].Inflammatory Bowel Diseases,2017,23(1):97-97.
[10]Feagan B G.Review article:economic issues in Crohn’s disease--assessing the effects of new treatments on health-related quality of life[J].Aliment Pharmacol Ther,2015,13(4):29-37.
[11]朱振浩,邱琛,张明,等.英夫利西单抗治疗的小肠克罗恩病患者不同肠段黏膜愈合情况分析[J].南方医科大学学报,2017,37(1):44-48.
[12]陈禾凤,陈冰,杨婉花.克罗恩病治疗中英夫利西单抗药物监测的临床意义[J].中国医院药学杂志,2016,36(22):2030-2034.
[13]廖诗乐,陈白莉,胡坤华,等.英夫利西单抗治疗克罗恩病黏膜愈合的血清差异蛋白质表达研究[J].中国病理生理杂志,2015,31(5):894-899.
[14]卜亚洲.英夫利西单抗辅助治疗克罗恩病伴不全性肠梗阻患者的疗效及安全性分析[J].中国卫生标准管理,2016,7(6):88-89.