乌司奴单抗联合硫唑嘌呤在克罗恩病肛瘘术后创面愈合中的应用效果分析

Analysis of application effect of ustekinumab combined with azathioprine on wound healing after anal fistula surgery for Crohn′s disease

目的分析乌司奴单抗联合硫唑嘌呤在克罗恩病肛瘘手术患者术后创面愈合中的效果。方法选取2021年4月至2023年7月丽水市中心医院收治的克罗恩病肛瘘手术患者80例为研究对象,采用随机数字表法分为观察组和对照组,各40例。对照组给予硫唑嘌呤片治疗,观察组在其基础上加用乌司奴单抗注射液治疗。治疗24周后比较2组克罗恩病活动指数(CDAI)评分、克罗恩病简化内镜(SES-CD)评分、临床缓解情况、炎症情况、不良反应情况、创面愈合情况、生活质量。结果治疗后,观察组CDAI、SES-CD评分均低于对照组,且观察组临床缓解情况优于对照组(均P<0.05)。治疗后,观察组血清白细胞介素12(IL-12)、IL-23、肿瘤坏死因子α水平均明显低于对照组(均P<0.05)。2组不良反应发生率比较差异无统计学意义(P=0.809)。治疗后观察组创面愈合总有效率高于对照组[85.0%(34/40)比57.5%(23/40)](P=0.007)。治疗后观察组生理功能、精神健康、社会功能、情感职能评分均显著高于对照组(均P<0.05)。结论乌司奴单抗联合硫唑嘌呤可有效促进克罗恩病肛瘘手术患者的术后创面愈合,缓解病情,改善预后。

Objective To analyze the effect of ustekinumab combined with azathioprine on wound healing after anal fistula surgery for Crohn′s disease.Methods A total of 80 patients with anal fistula surgery of Crohn′s disease admitted to Lishui City Central Hospital,Zhejiang Province from April 2021 to July 2023 were selected as the research objects.They were divided into observation group and control group by random number table method,with 40 cases in each group.The control group was treated with azathioprine tablets,and the observation group was treated with ustekinumab injection on the basis of azathioprine tablets.After 24 weeks of treatment,the Crohn′s disease activity index(CDAI)score,simplified endoscopy for Crohn′s disease(SES-CD)score,clinical remission,inflammation,adverse reactions,wound healing,and quality of life were compared between the two groups.Results After treatment,the scores of CDAI and SES-CD in the observation group were lower than those in the control group,and the clinical remission in the observation group was better than that in the control group(all P<0.05).After treatment,the levels of serum interleukin-12(IL-12),IL-23 and tumor necrosis factor-αin the observation group were significantly lower than those in the control group(all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P=0.809).After treatment,the total effective rate of wound healing in the observation group was higher than that in the control group[85.0%(34/40)vs 57.5%(23/40)](P=0.007).After treatment,the scores of physiological function,mental health,social function and emotional function in the observation group were significantly higher than those in the control group(all P<0.05).Conclusion Ustekinumab combined with azathioprine can effectively promote postoperative wound healing,relieve the condition and improve the prognosis of patients with Crohn′s disease undergoing anal fistula surgery.