英夫利昔治疗溃疡性结肠炎临床分析

Infliximab for ulcerative colitis

目的观察英夫利昔(infliximab,IFX)治疗中重度溃疡性结肠炎的临床疗效。方法应用IFX治疗的中重度活动期溃疡性结肠炎患者29例,观察IFX治疗0~6周患者临床表现、内镜学表现、实验室指标和不良反应。结果 29例患者IFX治疗后1周,腹泻、腹痛及发热症状均有好转;第6周时症状缓解率72.4%,黏膜愈合率48.3%,临床缓解率41.4%,C-反应蛋白[3.16(3.16,5.20)mg/L]、红细胞沉降率[7.00(2.00,10.75)mm/h]、D-二聚体水平[94.00(56.00,163.25)μg/L]较治疗前[5.40(3.16,42.60)mg/L、24.50(12.25,46.75)mm/h、362.50(172.50,632.50)μg/L]明显降低,血清白蛋白水平[40.20(35.60,42.20)g/L]较治疗前[36.50(33.40,39.85)g/L]明显升高,差异有统计学意义(P<0.05);治疗前、后血红蛋白、血小板计数、凝血酶原时间比较差异无统计学意义(P>0.05);不良反应发生率为27.6%。结论 IFX治疗中重度溃疡性结肠炎疗效确切。

Objective To evaluate the efficacy of infliximab(IFX)on moderate to severe ulcerative colitis(UC).Methods Twenty-nine patients with moderate to severe UC received IFX treatment,and the clinical manifestations,endoscopic findings,laboratory indexes and adverse reactions within 6weeks were observed.Results Among these 29 patients,diarrhea,abdominal pain and fever symptoms were all alleviated after 1-week treatment.The remission rate was72.4%,mucosal healing rate was 48.3%,and clinical remission rate was 41.4% after 6-week treatment.The levels of C-reactive protein,erythrocyte sedimentation rate and D-Dimer were 3.16(3.16,5.20)mg/L,7.00(2.00,10.75)mm/h and 94.00(56.00,163.25)μg/L after 6-week treatment,significantly lower than those before treatment(5.40(3.16,42.60)mg/L,24.50(12.25,46.75)mm/h,362.50(172.50,632.50)μg/L)(P<0.05),and the level of albumin was significantly higher after 6-week treatment(40.20(35.60,42.20)g/L)than that before treatment((36.50(33.40,39.85)g/L)(P<0.05).There were no significant differences in the levels of hemoglobin,blood platelet count and prothrombin time before and after treatment(P>0.05).The incidence of adverse reaction was 27.6%.Conclusion IFX is effective for moderate to severe UC.