Zhu Zhen-Hao, Qiu Chen, Zhang Ming, Chen Zhao, Xiang Cheng, Wang Xin-Ying
Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.E-mail:
Nan Fang Yi Ke Da Xue Xue Bao. 2017 Jan 20;37(1):44-48. doi: 10.3969/j.issn.1673-4254.2017.01.08.
To evaluate the mucosal healing in the terminal ileum, colon and small bowel in patients receiving infliximab treatment for small bowel Crohn's disease (SBCD).
The clinical data of 18 patients with SBCD treated with infliximab were analyzed for laboratory findings (routine blood tests, C-reative protein, and albumin), Crohn's disease activity index (CDAI), Lewis score (LS), Crohn's disease simplified endoscopic score (SES-CD) and adverse effects before and after 30 weeks of infliximab treatment.
SES-CD, LS, CDAI and CRP were all decreased significantly, but the body mass index and albumin were significantly increased in the 18 patients after 30 weeks of IFX treatment. Sixteen (88.9%) of the patients were in clinical remission, 10 (58.8%) showed terminal ileum and colonic mucosal healing, 4 (22.2%) showed small bowel mucosal healing, and 3 (17.6%) were in deep remission. The 4 patients with small bowel mucosal healing all showed terminal ileum and colon mucosal healing, and 6 patients with terminal ileum and colon mucosal healing did not show small bowel mucosal healing.
Infliximab treatment can effectively reduce inflammatory activity, induce and maintain clinical remission of SBCD and achieve mucosal healing; small bowel mucosal healing occurs later than terminal ileum and colonic mucosal healing, indicating the importance of small bowel mucosal healing in efficacy analysis of the treatment.
评估接受英夫利昔单抗治疗的小肠克罗恩病（SBCD）患者回肠末端、结肠和小肠的黏膜愈合情况。
分析18例接受英夫利昔单抗治疗的SBCD患者的临床资料，包括实验室检查结果（血常规、C反应蛋白和白蛋白）、克罗恩病活动指数（CDAI）、刘易斯评分（LS）、克罗恩病简化内镜评分（SES-CD）以及英夫利昔单抗治疗30周前后的不良反应。
18例患者经英夫利昔单抗治疗30周后，SES-CD、LS、CDAI和CRP均显著降低，但体重指数和白蛋白显著升高。16例（88.9%）患者达到临床缓解，10例（58.8%）显示回肠末端和结肠黏膜愈合，4例（22.2%）显示小肠黏膜愈合，3例（17.6%）达到深度缓解。4例小肠黏膜愈合的患者均显示回肠末端和结肠黏膜愈合，6例回肠末端和结肠黏膜愈合的患者未显示小肠黏膜愈合。
英夫利昔单抗治疗可有效降低炎症活动度，诱导并维持SBCD的临床缓解，实现黏膜愈合；小肠黏膜愈合比回肠末端和结肠黏膜愈合出现得晚，提示小肠黏膜愈合在治疗疗效分析中的重要性。
