英夫利昔在克罗恩病诱导缓解中的作用及随访研究

Study on the function of infliximab in inducing remission in Crohn＇s disease and followed-up

：目的 探讨英夫利昔（IFX）在克罗恩病诱导缓解中的作用并随访其诱导缓解的效果.方法 10例克罗恩病患者接受IFX（5 mg/kg）、5-氨基水杨酸（5-ASA）、硫唑嘌呤（AZA）诱导缓解和维持缓解治疗.在0、10、22和50周时进行克罗恩病活动指数（CDAI）、C-反应蛋白（CRP）、红细胞沉降率（ESR）、丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、总胆红素（TBil）、结合胆红素（CB）、肌酐（Scr）检测.在0、10和50周时进行克罗恩病简化内镜评分（SES-CD）.记录不良反应.结果 10周时所有患者均获缓解,CDAI、CRP、ESR和SES-CD均较0周时显著降低（P值均＜0.01）.1例患者在30周时因复发终止随访.50周时,有6例患者CDAI、CRP、ESR、SES-CD与10周时比较略增高,但差异无统计学意义（P值分别=0.2001、0.0600、0.1328、0.4230）,与0周时比较则均显著降低（P值分别=0.0005、0.0087、0.0054、0.0163）.所有患者均未出现严重不良反应.结论 IFX诱导CD缓解效果确切,部分CD患者在IFX诱导缓解后使用5-ASA和AZA维持缓解有效.

Objective To explore the function of infliximab in inducing remission in Crohn＇s disease and the effect of the inducing remission were followed up. Methods Ten patients with Crohn＇s disease received a infliximab, 5-aminosalicylic acid （5-ASA） and Azathioprine （AZA） therapy for inducing and maintenance remission. Crohn＇ s disease activity index （CDAI）, C-reactive protein （CRP）, erythrocyte sedimentation rate （ESR）, alanine aminotransferase （ALT）, apartate aminotransferase, （AST）, total bilirubin （TBil）, conjugated bilirubin, （CB）, creatinine （Scr） were evaluated at week 0, 10, 22 and 50. Simple endoscopic score for Crohn＇s disease （SES-CD） were evaluated at week 0, 10 and 50. Adverse reactions were also evaluated. Results At week 10, all patients achieved remission. The indicators of CDAI, CRP, ESR and SES-CD were significantly declined than those at week 0 （P〈0.01）. The follow-up was terminated in one patient due to the relapse at week 30. At week 50, the indicators of CDAI, CRP, ESR and SES-CD in six patients a little bit increased compared with those at week 10, but no statistic significant （P=0. 2001、0. 0600、0. 1328、0. 4230 respectively）, but significantly declined compared with those at week 0 （P =0.0005、0.0087、0.0054、0. 0163 respectively）. No severe adverse reaction was observed in all patients.Conclusions Infliximab showed an exact efficacy in inducing remission in Crohn＇s disease. And 5-ASA and AZA were effective for maintenance remission in part of the patients after infliximab induced remission.