Study on infliximab in the treatment of twenty-two cases of Crohn's disease with incomplete intestinal obstruction / 中华消化杂志

ABSTRACT

Objective To evaluate the safety and efficacy of infliximab (IFX) combined with conventional therapy in the treatment of Crohn's disease (CD) with incomplete intestinal obstruction.Methods From 2007 to 2013,22 cases of CD with incomplete intestinal obstruction were enrolled and were divided into IFX treatment group and conventional therapy group,each 11 cases.In conventional therapy group,patients were fasting or liquid food intake,received conventional therapy such as anti-infection and fluid supplement therapy to maintain water and electrolyte balance,long-term oral mesalazine,metacortandracin and imuran.In IFX treatment group,on the basis of conventional therapy patients received intravenous IFX 5 mg/kg at the 2nd,6th,14th,22nd and 30th week after admission.Regular blood test,liver function,erythrocyte sedimentation rate (ESR),C reaction protein (CRP) and CD active index (CDAI) of two groups were compared before and after treatment.Patients underwent endoscopy examination on admission day and the 30th week after treatment to evaluate the efficacy.The side effects were recorded during the period of treatment.The t test and Chi squaretest were used for comparison between groups.Results Compared with conventional therapy group,the average intestinal obstruction remission time of IFX treatment group shortened ((10.53±1.28) day vs (16.82±1.97) day) and the difference was statistically significant (t =2.985,P＜0.05).At the end of 30th week after treatment,clinical total effective rate of IFX treatment group and conventional therapy group was 9/11 and 7/11 (x2 ＝22.35,P＜0.05).Under endoscopy,total effective rate of these two groups was 7/11 and 5/11 (x2＝21.93,P＜0.05).At the end of 30th week after treatment,ESR,CRP and CDAI of IFX treatment group ((11.4±7.5) mm/1 h,(13.2±6.6) mg/L and 125.4±26.9) were all significantly lower than those on admission day ((31.3±5.7) mm/1 h,(45.3±7.6) mg/L and 240.5±35.2) (t=2.650,3.022,2.719,all P＜0.05).No serious side effects were observed in IFX treatment group and conventional therapy group during the treatment period.Conclusion For CD patients with incomplete intestinal obstruction,on the basis of conventional therapy,the addition of IFX could achieved better efficacy than conventional therapy alone.