维得利珠单抗治疗中重度溃疡性结肠炎疗效分析

Efficacy of vedolizumab in patients with moderate to severe ulcerative colitis

目的:观察维得利珠单抗治疗中重度溃疡性结肠炎(UC)的疗效。方法:回顾性分析2020年11月至2021年12月上海交通大学医学院附属新华医院消化内科治疗的25例中重度UC患者的临床资料。25例均使用维得利珠单抗治疗,30 min内输注完毕,第0、2、6周分别给药1次(300 mg),以诱导临床症状缓解;之后每8周相同剂量给药1次。治疗周期为22周,共给药5次。治疗第0周与第22周,检测血清C反应蛋白水平(CRP)和红细胞沉降率(ESR),行全结肠镜检查、改良的Mayo评分及Mayo内镜评分。记录治疗相关不良反应发生情况。结果:25例治疗22周后临床有效率为72%,缓解率为52%,黏膜愈合率为48%;治疗后ESR、CRP较治疗前下降(P<0.01)。治疗期间未发生严重不良反应。结论:维得利珠单抗可促进中重度UC肠黏膜愈合,有较高的临床有效率与临床缓解率,且具有良好的安全性。

Aim:To observe the efficacy of vedolizumab(VDZ) in the treatment of moderate to severe ulcerative colitis(UC).Methods:Clinical data of 25 patients with moderate to severe UC treated in the Department of Gastroenterology, Xinhua Hospital affiliated to School of Medicine of Shanghai Jiaotong University from November 2020 to December 2021 were retrospectively analyzed.All the patients were treated with VDZ,and the infusion was completed within 30 min at week 0,2,6,14 and 22 respectively.At week 0 and week 22,serum C-reactive protein level(CRP) and erythrocyte sedimentation rate(ESR) were measured, total colonoscopy was performed, and modified Mayo score and Mayo endoscopic score were performed.The treatment-related adverse reactions were recorded.Results:The clinical effective rate, remission rate and mucosal healing rate were 72%,52% and 48%,respectively.After treatment, ESR and CRP were significantly decreased(P<0.01).No serious adverse reactions occurred during the treatment.Conclusion:In the treatment of moderate to severe UC,VDZ could achieve high clinical effective rate and clinical remission rate, and promote intestinal mucosal healing with high safety.