英夫利昔治疗克罗恩病的初步研究

Preliminary Study on Treatment of Crohn's Disease with Infliximab

背景:近年克罗恩病(CD)的发病率不断升高,生物制剂英夫利昔(IFX)是一种肿瘤坏死因子-α单克隆抗体,可促进CD患者黏膜的愈合。目的:观察IFX治疗CD的疗效。方法:收集2008年7月～2009年6月上海中山医院的16例CD住院患者。根据CDAI评分评估CD严重程度并将患者分为常规治疗组和IFX组,分别予美沙拉秦+泼尼松以及IFX治疗。治疗8周后,比较两组CDAI评分、WBC、ESR、CRP和ALB水平。结果:11例轻度活动期CD患者接受常规治疗,5例中度活动期患者接受IFX治疗。治疗后,所有患者均取得临床缓解,其中2例伴肛门瘘管的轻度活动期患者经常规治疗无效后改用IFX治疗亦达到临床缓解。两组CDAI评分、ESR和CRP水平均较治疗前明显改善(P<0.05);IFX组CDAI评分的降低幅度高于常规治疗组,差异有统计学意义(P=0.019)。结论:IFX对CD的临床缓解优于常规治疗,并可促进常规治疗无效的肛门瘘管患者的愈合。

Background： The incidence of Crohn＇s disease （CD） is increasing in recent years. Infliximab （IFX）, an anti-tumor necrosis factor-or antibody, can enhance the healing of mucosal lesions in CD patients. Aims： To investigate the therapeutic effect of IFX on CD. Methods： Sixteen CD inpatients at Shanghai Zhongshan Hospital from July 2008 to June 2009 were enrolled. The severity of CD was evaluated by CDAI score, and the patients were divided into conventional therapy group and IFX group. Patients in the two groups were given mesalazine ＋ prednisone and IFX, respectively. After 8-week treatment, CDAI score, WBC, ESR, CRP and ALB levels were compared between the two groups. Results： Eleven mild active CD patients received conventional therapy, while 5 moderate active CD patients were given IFX. All the patients attained clinical remission, however, 2 mild active patients with anal fistula turned to IFX after failure of conventional therapy and remission was then attained. After treatmen4 CDAI score, ESR and CRP levels were improved in both two groups （P〈0.05）, however, the lowering of CDAI score in IFX group was significantly higher than that in conventional therapy group （P=0.019）. Conclusions： IFX is superior to conventional therapy for inducing clinical remission in CD, and can enhance the healing of anal fistula if conventional therapy fails.