Zhang Maochen, Zhang Tianyu, Hong Liwen, Zhang Chen, Zhou Jie, Fan Rong, Wang Lei, Wang Zhengting, Xu Bin, Zhong Jie
Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
Patient Prefer Adherence. 2018 May 21;12:879-885. doi: 10.2147/PPA.S156883. eCollection 2018.
Patients with newly diagnosed Crohn's disease (CD) are associated with impaired physical and psychological well-being. These psychological characteristics are dynamic with the course of disease and could be influenced by medical treatment. Infliximab is effective and widely used in moderate-to-severe CD patients. The aim of this study was to evaluate the improvement of psychological status after infliximab treatment in patients with newly diagnosed CD.
Newly diagnosed moderate-to-severe CD patients were prospectively enrolled in our study. Infliximab 5 mg/kg was administered at weeks 0, 2, 6, 14, 22, and 30. Outcomes including disease severity, illness perceptions, coping strategies, anxiety, depression, and quality of life (QoL) were measured at baseline, week 14, and week 30.
Eighty-two patients completed our study. The rates of clinical remission at weeks 14 and 30 were 59/82 (72.0%) and 58/82 (70.7%), respectively. Patients who achieved clinical remission at weeks 14 and 30 significantly improved in illness perceptions (<0.001 and <0.001), maladaptive coping (=0.005 and 0.004), anxiety (<0.001 and <0.001), depression (=0.004 and 0.004), and QoL (<0.001 and <0.001). However, emotion-focused coping and problem-focused coping remained unchanged. For infliximab nonresponders, no significant changes were seen in illness perceptions, coping strategies, anxiety, depression, or QoL at week 14 or 30.
Effective infliximab treatment not only led to clinical remission in patients with newly diagnosed moderate-to-severe CD but also improved their psychological status including illness perceptions, maladaptive coping, anxiety, depression, and QoL.
新诊断的克罗恩病（CD）患者存在身体和心理健康受损的情况。这些心理特征会随着疾病进程而动态变化，并且可能受到医学治疗的影响。英夫利昔单抗有效且广泛应用于中重度CD患者。本研究的目的是评估英夫利昔单抗治疗对新诊断的CD患者心理状态的改善情况。
新诊断的中重度CD患者前瞻性纳入本研究。在第0、2、6、14、22和30周给予英夫利昔单抗5mg/kg。在基线、第14周和第30周测量包括疾病严重程度、疾病认知、应对策略、焦虑、抑郁和生活质量（QoL）等结果。
82例患者完成了本研究。第14周和第30周的临床缓解率分别为59/82（72.0%）和58/82（70.7%）。在第14周和第30周达到临床缓解的患者在疾病认知（<0.001和<0.001）、适应不良应对（=0.005和0.004）、焦虑（<0.001和<0.001）、抑郁（=0.004和0.004）和QoL（<0.001和<0.001）方面有显著改善。然而，以情绪为中心的应对和以问题为中心的应对保持不变。对于英夫利昔单抗无反应者，在第14周或第30周，疾病认知、应对策略、焦虑、抑郁或QoL均无显著变化。
有效的英夫利昔单抗治疗不仅使新诊断的中重度CD患者实现临床缓解，还改善了他们的心理状态，包括疾病认知、适应不良应对、焦虑、抑郁和QoL。
