Page 114 - 南京医科大学学报自然科学版

南京医科大学学报（自然科学版） 第41卷第7期
·1044 · Journal of Nanjing Medical University（Natural Sciences） 2021年7月

·临床医学·

高危因素对英夫利西单抗治疗克罗恩病疗效的影响

王 迪，李林珍，崔秀芳，张 丽，吴莎莎，张红杰 *
南京医科大学第一附属医院消化科，江苏 南京 210029

［摘 要］ 目的：探究高危因素对英夫利西单抗（infliximab，IFX）治疗克罗恩病（Crohn’s disease，CD）临床疗效的影响。方法：
纳入 61 例接受 IFX 治疗的 CD 患者，根据年龄、广泛肠道病变、上消化道病变和肛周病变等高危因素的数目，将 CD 患者分
为 1 个高危因素组（组1）、2个高危因素组（组2）及2个以上高危因素组（组3），并根据是否广泛肠道病变或合并肛周病变进一
步分组，比较各组治疗后的临床应答率和黏膜愈合率，评估高危因素对IFX疗效的影响。结果：IFX治疗后第2、6周，组1临床
应答率均高于组2及组3（P < 0.05），而3组第14周临床应答率及第38周黏膜愈合率差异无统计学意义。非广泛病变亚组第2
周（P=0.013）及第6周（P=0.021）临床应答率均高于广泛病变组，两组第14周临床应答率及第38周黏膜愈合率差异无统计学
意义。无肛周病变组第2、6、14周临床应答率及第38周黏膜愈合率较合并肛周病变组有增高趋势，但差异均无统计学意义。
结论：高危因素越少的CD患者可能越早获得临床应答，但高危因素可能并不影响CD患者的最终临床应答率及肠道黏膜愈合率。
［关键词］ 克罗恩病；临床应答率；黏膜愈合率；高危因素；英夫利西单抗
［中图分类号］ R574 ［文献标志码］ A ［文章编号］ 1007⁃4368（2021）07⁃1044⁃05
doi：10.7655/NYDXBNS20210717

Influence of high risk factors on the efficacy of infliximab in the treatment of Crohn's disease

WANG Di，LI Linzhen，CUI Xiufang，ZHANG Li，WU Shasha，ZHANG Hongjie *
Department of Gastroenterology，the First Affiliated Hospital of Nanjing Medical University，Nanjing 210029，China

［Abstract］ Objective：To evaluate the effect of high⁃risk factors on infliximab（IFX）efficacy in patients with Crohn’s disease（CD）.
Methods：Sixty⁃one patients with CD who received IFX treatment（09/2012⁃05/2019）were recruited. We performed a retrospective
study comparing IFX efficacy in patients with one（group 1），two（group 2）and more than two high⁃risk factors（group 3）. Patients were
also subdivided according to extensive intestine lesions and perianal lesions. The rate of clinical response/mucosal healing was used as
evaluation index. Results：At week 2 and week 6，group 1 achieved higher clinical response rate than group 2 and group 3（P < 0.05），
while the clinical response rate at week 14 and the mucosal healing rate at week 38 among groups were not significantly different.
Patients without extensive intestine lesions achieved higher clinical response rate than those with extensive intestine lesions at week 2
（P=0.013）and week 6（P=0.021），while the clinical response rate at week 14 and the mucosal healing rate at week 38 were not
significantly different between groups with extensive intestine lesions or not（P > 0.05）. Patients with perianal lesions or not had no
significant difference on the clinical response rate and mucosal healing rate after treatment（P > 0.05）. Conclusion：Patients with fewer
high⁃risk factors may achieve clinical response earlier，but high⁃risk factors may not affect the final clinical response and mucosal
healing rate in patients with CD.
［Key words］ Crohn’s disease；clinical response rate；mucosal healing rate；high⁃risk factors；infliximab
［J Nanjing Med Univ，2021，41（07）：1044⁃1048］

克罗恩病（Crohn’s disease，CD）是一种病因不 何部位，常为缓解期和活动期交替 ［1-2］ 。传统治疗药
明的消化道慢性炎症性疾病，可发生于消化道的任 物包括糖皮质激素、5⁃氨基水杨酸制剂及免疫抑制
剂。然而，传统药物治疗只有约 50%的 CD 患者可
［3］
［基金项目］ 国家自然科学基金（81770553，82070568） 获得缓解，且常伴随不良反应 。因此，寻找更安全
∗ 有效的药物至关重要。
通信作者（Corresponding author），E⁃mail：hjzhang06@163.com