中国实用内科杂志2018，Vol.38Issue(3)：217-222,6.DOI:10.19538/j.nk2018030111
英夫利昔单抗治疗炎症性肠病95例不良反应及其危险因素分析
Risk factors of adverse events associated with infliximab treatment for inflammatory bowel disease.
摘要
Abstract
Objective To explore the risk factors of adverse events in patients with inflammatory bowel disease treated with infliximab(IFX). Methods From March 2009 to September 2017, demographic and clinical data of 95 IBD patients (65 CD and 30 UC)who received IFX treatment (≥3 infusions) were retrospectively analyzed. Based on presence or absence of adverse events, the enrolled patients were divided into adverse effect group and non-adverse effect group. Wilcoxon rank sum test was used for comparison of measurement data between groups. Chi-square test was performed for the rate comparison. Multivariate analysis was made with Logistic regression. Results (1)The rate of male to female in 95 patients was 3:1. The average age of onset was (24. 4±9. 7)years old. The age of receiving the first treatment with IFX was (31. 2±11. 1)years. The mean disease duration prior to IFX was (6. 9±5. 8) years. The median duration of IFX therapy was 7. 3 months. (2) In the 95 patients, 24(25. 2％) patients had at least one adverse event, and 6 patients had at least two adverse events. There were 10(10.5％) allergic reactions, 16(16. 8％)infections, 2(2. 1％)leukopenia and 2(2. 1％)liver dysfunction. The median length from adverse event to the first IFX infusion was 5. 2 months. (3) IFX was discontinued in 7(29. 2％) out of 24 patients with adverse events. All patients had been treated effectively, and none died. (4) The level of hsCRP >9 mg/L at baseline (OR 5. 119, 95％ Cl 1. 737～15. 089, P=0.003), non-structuring type (OR 4. 914, 95％ Cl 1. 007～23. 970, P=0.049) and severe disease activity (OR 0.067, 95％ Cl 0.007～0.678, P=0.022) were risk factors of adverse reactions. Conclution IFX is relatively safe for IBD. The level of hsCRP >9 mg/L at baseline, non-stricturing type and severe disease are associated with a higher risk of adverse reactions.关键词
炎症性肠病/英夫利昔单抗/不良反应Key words
inflammatory bowel disease/infliximab/adverse reactions分类
医药卫生引用本文复制引用
刘爱玲,吕红,李玥,杨红,钱家鸣..英夫利昔单抗治疗炎症性肠病95例不良反应及其危险因素分析[J].中国实用内科杂志,2018,38(3):217-222,6.基金项目
国家卫生计生委公益性行业科研专项(201002020) （201002020）
中国医学科学院医学与健康科技创新工程(2016-I2M-3-001) （2016-I2M-3-001）
国家自然科学基金(81570505) （81570505）
国家科技部973计划(2015CB943203) （2015CB943203）
