免疫抑制剂辅助英夫利昔单抗治疗克罗恩病80例临床研究
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摘要
目的探讨免疫抑制剂短疗程辅助英夫利昔单抗(IFX)治疗克罗恩病的效果。方法选择2014年1月—2016年1月收治的克罗恩病患者160例,随机分为对照组与观察组,各80例。两组均予以常规治疗,对照组加用IFX,观察组在对照组基础上加用短疗程的免疫抑制剂(硫唑嘌呤)。比较两组干预后的治疗效果,比较两组治疗前后实验室指标(IL-17、IL-23、CRP、ESR、ALT)及克罗恩病活动指数(CDAI),比较两组用药期间不良反应发生率及随访12个月后复发率。计量资料比较采用t检验,计数资料比较采用χ2检验,P<0.05为差异有统计学意义。结果治疗后,观察组总有效率(96.25%)高于对照组(87.50%),IL-17、IL-23、CRP及CDAI指数均小于对照组,复发率(5.00%)低于对照组(15.00%),差异有统计学意义(均P<0.05);观察组不良反应发生率(5.00%)与对照组(2.50%)比较,差异无统计学意义(P>0.05)。结论免疫抑制剂辅助英夫利昔单抗治疗克罗恩病可减轻炎症反应,降低中期复发率。
Objective To investigate the effects of immunosuppressive agents combined with infliximab for Crohn's disease.Methods A total of 160 cases with Crohn's disease from January 2014 to January 2016 were selected and randomly divided into control group and observation group,80 cases in each group.The two groups were given conventional treatment, the control group was treated with IFX, the observation group was treated with a short course of immunosuppressant(azathioprine) on the basis of the control group. The therapeutic effects of the two groups were compared,the laboratory indicators(IL-17, IL-23, CRP, ESR, ALT) and Crohn's disease activity index in the two groups before and after treatment were compared,the incidence of adverse reactions in the two groups and the recurrence rate after 12 months follow-up were compared.The measurement data were compared by t test, and the count data were compared by χ2 test. P<0.05 was considered statistically significant.Results After treatment, the total efficiency of the observation group(96.25%) was higher than that in the control group(87.50%).Levels of IL-17, IL-23, CRP and CDAI index were lower than those in the control group, the recurrence rate(5%) was lower than that in the control group(15%), and the differences were statistically significant(all P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the observation group(5%) and the control group(2.50%)(P>0.05).Conclusions Patients with crohn's disease are treated with immunosuppressive therapy on the basis of IFX, which can not only reduce the inflammatory response, but also have low intermediate recurrence rate.
Objective To investigate the effects of immunosuppressive agents combined with infliximab for Crohn's disease.Methods A total of 160 cases with Crohn's disease from January 2014 to January 2016 were selected and randomly divided into control group and observation group,80 cases in each group.The two groups were given conventional treatment, the control group was treated with IFX, the observation group was treated with a short course of immunosuppressant(azathioprine) on the basis of the control group. The therapeutic effects of the two groups were compared,the laboratory indicators(IL-17, IL-23, CRP, ESR, ALT) and Crohn's disease activity index in the two groups before and after treatment were compared,the incidence of adverse reactions in the two groups and the recurrence rate after 12 months follow-up were compared.The measurement data were compared by t test, and the count data were compared by χ2 test. P<0.05 was considered statistically significant.Results After treatment, the total efficiency of the observation group(96.25%) was higher than that in the control group(87.50%).Levels of IL-17, IL-23, CRP and CDAI index were lower than those in the control group, the recurrence rate(5%) was lower than that in the control group(15%), and the differences were statistically significant(all P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the observation group(5%) and the control group(2.50%)(P>0.05).Conclusions Patients with crohn's disease are treated with immunosuppressive therapy on the basis of IFX, which can not only reduce the inflammatory response, but also have low intermediate recurrence rate.
引文
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[3]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.
[4]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.
[5]中华医学会消化病学分会炎症性肠病学组.炎症性肠病诊断与治疗的共识意见(2012年·广州)[J].中华内科杂志,2012,51(10):763-781.
[6]英国胃肠病学会炎症性肠病组.成人炎症性肠病处理指南[J].国际消化病杂志,2005,25(3):57-61.
[7]沈玲燕,杜娟,张冰凌,等.不同胶囊内镜评分指数评估克罗恩病活动程度的相关性分析[J].中华消化杂志,2015,35(10):654-658.
[8]Cleynen I,Boucher G,Jostins L,et al.Inherited determinants of Crohn's disease and ulcerative colitis phenotypes:a genetic association study[J].The Lancet,2016,387(10014):156-167.
[9]田丰,解莹,闫博.早期应用英夫利昔单抗联合硫唑嘌呤治疗合并2个以上预后不良高危因素克罗恩病疗效及安全性研究[J].中国实用内科杂志,2017,37(3):242-246.
[10]辛玉,吕红,马莉,等.免疫抑制剂预防克罗恩病术后复发的临床研究[J].中华消化杂志,2016,36(8):532-537.
[11]胡慧琴,姜泊,薛琪,等.硫唑嘌呤对克罗恩病术后复发的影响[J].中华消化杂志,2016,36(7):486-489.
[12]汪燕燕,苏涌,杨春兰,等.应用硫唑嘌呤治疗炎症性肠病致白细胞减少症的相关因素分析[J].中国药房,2016,27(17):2348-2351.
[13]刘小伟,龚玲琪.免疫抑制剂在炎症性肠病的应用[J].内科理论与实践,2017,12(3):163-167.
[2]伏桂香,陈尼维.克罗恩病肠壁纤维化机制的研究进展[J].国际消化病杂志,2016,36(1):22-24.
[3]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.
[4]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.
[5]中华医学会消化病学分会炎症性肠病学组.炎症性肠病诊断与治疗的共识意见(2012年·广州)[J].中华内科杂志,2012,51(10):763-781.
[6]英国胃肠病学会炎症性肠病组.成人炎症性肠病处理指南[J].国际消化病杂志,2005,25(3):57-61.
[7]沈玲燕,杜娟,张冰凌,等.不同胶囊内镜评分指数评估克罗恩病活动程度的相关性分析[J].中华消化杂志,2015,35(10):654-658.
[8]Cleynen I,Boucher G,Jostins L,et al.Inherited determinants of Crohn's disease and ulcerative colitis phenotypes:a genetic association study[J].The Lancet,2016,387(10014):156-167.
[9]田丰,解莹,闫博.早期应用英夫利昔单抗联合硫唑嘌呤治疗合并2个以上预后不良高危因素克罗恩病疗效及安全性研究[J].中国实用内科杂志,2017,37(3):242-246.
[10]辛玉,吕红,马莉,等.免疫抑制剂预防克罗恩病术后复发的临床研究[J].中华消化杂志,2016,36(8):532-537.
[11]胡慧琴,姜泊,薛琪,等.硫唑嘌呤对克罗恩病术后复发的影响[J].中华消化杂志,2016,36(7):486-489.
[12]汪燕燕,苏涌,杨春兰,等.应用硫唑嘌呤治疗炎症性肠病致白细胞减少症的相关因素分析[J].中国药房,2016,27(17):2348-2351.
[13]刘小伟,龚玲琪.免疫抑制剂在炎症性肠病的应用[J].内科理论与实践,2017,12(3):163-167.