卢翀　郑小娟　胡益冰　李子美

[關键词] 英夫利西单抗;克罗恩病;免疫功能;临床效果

[中图分类号] R574.1          [文献标识码] B          [文章编号] 1673-9701（2021）17-0045-04

Effects of AZA+IFX combined therapy on Crohn′s disease and its effect on intestinal permeability in patients

LU Chong   ZHENG Xiaojuan   HU Yibing   LI Zimei

Department of Gastroenterology， Jinhua Central Hospital of Zhejiang Province， Jinhua   321000，China

[Abstract] Objective To explore the clinical effects of different treatment schemes in the treatment of Crohn′s disease （CD） patients， and to analyze the most suitable treatment scheme based on the specific data. Methods A total of 98 patients with diagnosed CD treated in Jinhua Central Hospital from January 2018 to December 2019 were divided into two groups， with 50 in the control group and 48 in the experimental group. The control group was treated with azathioprine，and the experimental group was treated with infliximab combined with azathioprine.Clinical efficacy， serum levels of inflammatory factors， tumor necrosis factor-α（TNF-α）， interleukin-12 （IL-12） and interleukin-10 （IL-10）， albumin （ALB）， hypersensitive C-reactive protein （CRP） and erythrocytic sedimentation rates （ESR） before and after treatment were compared between the two groups. Results The clinical efficacy of the experimental group was 96.00%， which was higher than 81.25% of the control group， and the difference was statistically significant（P<0.05）. After treatment， the value of IL-10 in the experimental group was higher than those in the control group， while the values of IL-12 and TNF-α in the experimental group were lower than those in the control group， and the differences were statistically significant （P<0.05）. Statistically significant differences were also observed in those values between the two groups after treatment and before treatment（P<0.05）. After treatment， ALB levels in the experimental group were increased， while CRP and ESR levels were decreased，with statistically significant differences（P<0.05）. Statistically significant differences were observed between the two groups after and before treatment（P<0.05）. Conclusion The treatment of infliximab combined with azathioprine can effectively improve the immune function and inflammatory cytokines in patients with Crohn′s disease， and the therapeutic effect is satisfactory.

[Key words] Infliximab （IFX）; Crohn′s disease （CD）; Immune function; Clinical effect

克罗恩病（Crohn′s disease，CD）是一种严重影响胃肠道的疾病[1]。目前，CD尚无根治的手段，病情常反复发作。临床上主要使用氨基水杨酸制剂，免疫抑制类药物及生物制剂等进行长期维持治疗，其中硫唑嘌呤（Azathioprine，AZA）是CD缓解期治疗的最常用免疫抑制药物之一。同时也使用英夫利西单抗（Infliximab，IFX）这一种生物制剂用于治疗CD，有助于提高患者黏膜愈合率。临床研究显示改善CD患者的免疫功能和炎症反应是当前治疗CD的重要策略[2]。当前，为了保证CD患者的治疗效果，临床上大多采用英夫利昔单抗联合硫唑嘌呤的治疗，这样一来不仅能够达到一定的临床疗效，还能降低患者在治疗过程中出现不良反应的概率，为CD患者的治疗带来了更多的保障。本文结合临床实际，重点探究AZA+IFX联合法治疗克罗恩病的效果及对CD患者肠道通透性的影响，现报道如下。

1 资料与方法

1.1 一般资料

选取2018年1月至2020年3月金华市中心医院消化内科CD患者98例，其中男52例，女46例，年龄17～69岁，平均（36.9±4.2）岁。按照CD治疗方式，随机将患者分为AZA单药治疗组（对照组）与AZA+IFX联合治疗组（试验组）。其中AZA组平均年龄（36.1±2.1）岁;AZA+IFX组平均年龄（33.6±2.3）岁。两组患者的性别、年龄比较，差异无统计学意义（P>0.05），具有可比性。另外，在进行本次研究之前征得全部患者的同意，同时向医院医学伦理委员会提出申请并通过。

所有入选患者的诊断均符合炎症性肠病诊断标准[3]。纳……