中国药房2017，Vol.28Issue(35)：4947-4951,5.DOI:10.6039/j.issn.1001-0408.2017.35.14
英夫利西单抗治疗克罗恩病的疗效、安全性观察及影响因素分析
Efficacy and Safety Observation of Infliximab in the Treatment of Crohn's Disease and Analysis of Influen-tial Factors
摘要
Abstract
OBJECTIVE:To observe therapeutic efficacy and safety of infliximab (IFX) in the treatment of Crohn's disease (CD),and to investigate its influential factors. METHODS:In retrospective study,a total of 120 CD patients received IFX treat-ment in our hospital during Jan.-Dec. 2015 were selected as research objects. All patients were given IFX for injection 5 mg/kg intra-venously at 0,2nd,6th week and later every 8 weeks continously. Therapeutic efficacy indexes(body weight,CRP,ESR,WBC, mucosal healing under endoscope),liver and renal indexes (ALT,AST,AKP,γ-GT,TB,DB,Cr),the occurrence time of ADR,organs/systems involved,clinical manifestations and outcomes were compared before and after treatment. Influential factors were analyzed. RESULTS:Compared with before medication,body weight of patients were increased significantly,while ESR were decreased significantly,with statistical significance (P<0.05). There was positively correlation between above two indexes (r=0.275,P=0.016). Mucosal healing was found in 78.57％ of patients by colonoscopy. There was statistical significance in the levels of AST,AKP and Cr before and after treatment(P<0.05),but those indexes were increased slightly. AKP exceeded 2 times the upper limit of normal value in only 1 case,but AST did not exceed 2 times the upper limit of normal limit,Cr did not exceed the upper limit of normal value. There was no statistical significance in CRP,WBC or other liver and renal function indexes before and af-ter treatment(P>0.05). There were 24 cases of ADR with incidence of 20.00％. Respiratory system,digestive system,skin mucous membrane,body defense and other organs/systems were involved,mainly manifestating as uper respiratory tract infetion,liver func-tion indexes order etc. Ten patients(41.67％)delayed the treatment,and 6 cases(25.00％)discontinued. Standard rate of ESR in pa-tients with regular/primary medication (78.21％) was higher than those with intermittent medication history (57.14％),but without statistical significance(P>0.05). Combined use of mesalazine had no significant effect on the increase of AST and AKP(P=0.002). CONCLUSIONS:IFX significantly increases body weight of CD patients,decreases ESR and improves mucosal healing. It shows def-inite therapeutic efficacy. It is suggested that CD patients should use IFX regularly. The overall safety of IFX is good,but it may cause transfusion reaction and transient increase of liver function index. So,the patient's condition should be closely monitored during the in-fusion.关键词
英夫利西单抗/克罗恩病/疗效/安全性/影响因素Key words
Infliximab/Crohn's disease/Therapeutic efficacy/Safety/Influential factor分类
医药卫生引用本文复制引用
陈禾凤,杨婉花,姚玮艳..英夫利西单抗治疗克罗恩病的疗效、安全性观察及影响因素分析[J].中国药房,2017,28(35):4947-4951,5.基金项目
上海市临床药学重点专科建设项目 （）
