英夫利西单抗谷浓度、抗英夫利西单抗抗体及相关指标评估克罗恩病患者疾病活动的临床意义

Clinical significance of infliximab trough level,anti-infliximab antibody and relevant indicators in evaluating disease activity in patients with Crohn’s disease

目的探讨英夫利西单抗(IFX)谷浓度、抗IFX抗体及相关指标评估克罗恩病(CD)疾病活动的临床意义。方法根据CD活动指数评分将接受IFX治疗的45例CD患者分为缓解期组(<150分,32例)和活动期组(≥150分,13例)。比较两组IFX谷浓度、抗IFX抗体及相关指标水平。结果缓解期组IFX谷浓度和抗IFX抗体均与活动期组相仿(P>0.05)。抗IFX抗体弱阳性和抗IFX抗体阳性患者IFX谷浓度均低于抗IFX抗体阴性患者[1.10(0.30,2.05)μg/mL和0.30(0.30,0.63)μg/mL vs.3.40(1.83,6.63)μg/mL](P<0.01)。缓解期组ESR和CRP低于活动期组,而白蛋白(Alb)高于活动期组(P<0.05)。CRP是CD疾病活动的独立影响因素(P<0.05),而尚未发现ESR、Alb、Hb、IFX谷浓度和抗IFX抗体是CD疾病活动的独立影响因素(P>0.05)。结论抗IFX抗体阳性CD患者IFX谷浓度低于抗IFX抗体阴性患者。CRP是CD疾病活动的独立影响因素,而IFX谷浓度和抗IFX抗体对CD疾病活动的影响不明显。

Objective To explore the clinical significance of infliximab(IFX)trough level,anti-IFX antibody and relevant indicators in evaluating disease activity in the patients with Crohn’s disease(CD).Methods According to the CD activity index score,45 CD patients received IFX treatment were divided into remission stage group(<150 points,32 cases)and active stage group(≥150 points,13 cases).The IFX trough level,anti-IFX antibody and relevant indicators were compared between the two groups.Results IFX trough level and anti-IFX antibody in remission stage group were similar to those in active stage group(P>0.05).IFX trough level in the patients with weak or positive anti-IFX antibody was lower than that in the patients with negative anti-IFX antibody[1.10(0.30,2.05)μg/mL and 0.30(0.30,0.63)μg/mL vs.3.40(1.83,6.63)μg/mL](P<0.01).ESR and CRP were lower,while albumin was higher in remission stage group than those in active stage group(P<0.05).CRP was the independent influencing factor for CD disease activity(P<0.05),but ESR,albumin,Hb,IFX trough level and anti-IFX antibody were not the independent influencing factors for CD disease activity(P>0.05).Conclusion IFX trough level in CD patients with positive anti-IFX antibody is lower than that in those with negative anti-IFX antibody.CRP is an independent influencing factor for CD disease activity,while IFX trough level and anti-IFX antibody have no significant effect on CD disease activity.