摘要
目的 评价英夫利西单克隆抗体（IFX）联合常规治疗对CD伴不完全性肠梗阻患者的有效性和安全性.方法 纳入2007年至2013年间CD伴不完全性肠梗阻患者22例,分为IFX治疗组及常规治疗组各11例.常规治疗组患者予禁食或流质饮食、抗感染、补液维持水电平衡等内科常规治疗,并予美沙拉嗪、泼尼松、硫唑嘌呤长期口服.IFX治疗组在常规治疗的基础上,在入院时,治疗第2、6、14、22、30周给予IFX 5 mg/kg静脉滴注.比较两组在治疗前后的血常规、肝功能、ESR、CRP,记录CD疾病活动指数（CDAI）,入院时、治疗第30周末行肠镜检查评价治疗疗效,治疗期间记录不良反应发生情况.组间比较采用t检验和卡方检验.结果 IFX治疗组较常规治疗组患者的肠梗阻平均缓解时间缩短[（10.53±1.28）d比（16.82±1.97）d],差异有统计学意义（t=2.985,P＜0.05）.治疗第30周末,IFX治疗组与常规治疗组患者的临床总有效率分别为9/11、7/11（x2＝22.35,P＜0.05）,两组患者内镜下总有效率分别为7/11、5/11,差异有统计学意义（x2＝21.93,P＜0.05）.治疗第30周末IFX治疗组ESR[（11.4±7.5） mm/1 h]和CRP水平[（13.2±6.6） mg/L]、CDAI（125.4±26.9）较入院时[分别为（31.3±5.7） mm/1 h,（45.3±7.6）mg/L和240.5±35.2]均显著降低,差异均有统计学意义（t＝2.650、3.022、2.719,P均＜0.05）.治疗期间IFX治疗组和常规治疗组均无严重不良反应发生.结论 对于CD伴不完全性肠梗阻的患者,在内科常规治疗的基础上,加用IFX的疗效明显好于单用常规治疗.
Objective To evaluate the safety and efficacy of infliximab （IFX） combined with conventional therapy in the treatment of Crohn＇s disease （CD） with incomplete intestinal obstruction.Methods From 2007 to 2013,22 cases of CD with incomplete intestinal obstruction were enrolled and were divided into IFX treatment group and conventional therapy group,each 11 cases.In conventional therapy group,patients were fasting or liquid food intake,received conventional therapy such as anti-infection and fluid supplement therapy to maintain water and electrolyte balance,long-term oral mesalazine,metacortandracin and imuran.In IFX treatment group,on the basis of conventional therapy patients received intravenous IFX 5 mg/kg at the 2nd,6th,14th,22nd and 30th week after admission.Regular blood test,liver function,erythrocyte sedimentation rate （ESR）,C reaction protein （CRP） and CD active index （CDAI） of two groups were compared before and after treatment.Patients underwent endoscopy examination on admission day and the 30th week after treatment to evaluate the efficacy.The side effects were recorded during the period of treatment.The t test and Chi squaretest were used for comparison between groups.Results Compared with conventional therapy group,the average intestinal obstruction remission time of IFX treatment group shortened （（10.53±1.28） day vs （16.82±1.97） day） and the difference was statistically significant （t =2.985,P＜0.05）.At the end of 30th week after treatment,clinical total effective rate of IFX treatment group and conventional therapy group was 9/11 and 7/11 （x2 ＝22.35,P＜0.05）.Under endoscopy,total effective rate of these two groups was 7/11 and 5/11 （x2＝21.93,P＜0.05）.At the end of 30th week after treatment,ESR,CRP and CDAI of IFX treatment group （（11.4±7.5） mm/1 h,（13.2±6.6） mg/L and 125.4±26.9） were all significantly lower than those on admission day （（31.3±5.7） mm/1 h,（45.3±7.6） mg/L and 240.5±35.2） （t=2.650,3.022,2.719,all P＜
出处
《中华消化杂志》
CAS
CSCD
北大核心
2014年第8期539-543,共5页
Chinese Journal of Digestion
关键词
CROHN病
肠梗阻
英夫利西
Crohn disease
Intestinal obstruction
Infliximab
