Efficacy of infliximab in the treatment of small intestinal Crohn's disease and its effects on simple endoscopic score for Crohn's disease, routine blood test and nutritional indexes / 中国基层医药

ABSTRACT

Objective:To investigate the efficacy of infliximab in the treatment of small intestinal Crohn's disease and its effects on simple endoscopic score for Crohn's disease (SES-CD), routine blood test and nutritional indexes.Methods:Eighty-four patients with small intestinal Crohn's disease who received treatment in Zhejiang Xin'an International Hospital between November 2019 and March 2021 were included in this study. They were randomly divided into control and observation groups with 42 patients each. The control group was treated with azathioprine. The observation group was treated with azathioprine and infliximab. Clinical efficacy, SES-CD score, hemoglobin (Hb) level, white blood cell (WBC) count, platelet (PLT), albumin (ALB), pre-albumin (PA) and total protein (TP) levels pre- and post-treatment were compared between the two groups.Results:Response rate in the observation group was significantly higher than that in the control group [92.8% (39/42) vs. 73.8% (31/42), χ2 = 5.48, P < 0.05]. There was no significant difference in SES-CD score pre-treatment between the control and observation groups [(7.24 ± 1.30) points vs. (7.33 ± 1.27) points, t = -0.34, P > 0.05]. After treatment, SES-CD scores in the control and observation groups were (5.12 ± 1.17) points and (4.22 ± 0.98) points, respectively, which were significantly decreased compared with those before treatment ( t = 11.01, 14.66, both P < 0.001). After treatment, SES-CD score in the observation group was significantly lower than that in the control group ( t = 4.19, P < 0.001). Before treatment, there were no significant differences in Hb level [(110.23 ± 16.19) g/L vs. (112.27 ± 15.98) g/L], WBC count [(7.61 ± 2.54) × 10 9 g/L vs. (7.47 ± 2.61) × 10 9 g/L] and PLT level [(420.14 ± 130.27) × 10 9 g/L vs. (419.23 ± 131.15) × 10 9 g/L] between the control and observation groups ( t = -0.58, 0.25, 0.03, all P > 0.05). After treatment, Hb level [(120.25 ± 14.36) g/L and (130.17 ± 12.24) g/L ], WBC count [(6.01 ± 1.88)× 10 9 g/L, (5.13 ± 1.96) × 10 9 g/L) and PLT level [(321.79 ± 110.21) × 10 9 g/L, (267.25 ± 100.23) × 10 9 g/L] in the control and observation groups were significantly decreased compared with those before treatment ( tcontrol group = -4.70, 6.60, 8.02, tobservaton group = -7.91, 3.50, 4.99, all P < 0.05). Hb level post-treatment in the observation group was significantly higher than that in control group ( t = -3.41, P < 0.05) . WBC count and PLT level in the observation group were significantly lower than those in the control group ( t = 2.10, 2.37, both P < 0.05). Before treatment, there were no significant differences in ALB level [(33.14 ± 5.66) g/L vs. (32.98 ± 5.73) g/L], PA level [(220.17 ± 71.14) mg/L vs. (219.89 ± 70.26) mg/L], TP level [(61.23 ± 8.21) g/L vs. (60.95 ± 8.17) g/L] between control and observation groups ( t = 0.12, 0.01, 0.15, all P > 0.05). After treatment, ALB level [(38.29 ± 6.13) g/L, (44.23 ± 6.07) g/L], PA level [(281.14 ± 85.23) mg/L, (320.27 ± 82.01) mg/L], TP level [(67.23 ± 7.22) g/L, (73.28 ± 6.97) g/L] in the control and observation groups were significantly increased compared with those before treatment ( tcontrol group = -7.90, -4.30, -5.08, tobservation group = -13.76, -7.52, -11.45, all P < 0.05). After treatment, ALB, PA and TP levels in the observation group were significantly higher than those in the control group ( t = -4.46, -2.14, -3.89, all P < 0.05). Conclusion:Infliximab is highly effective on small intestinal Crohn's disease. It can effectively decrease SES-CD score, improve routine blood parameters and nutritional indexes, alleviate azathioprine-induced myelosuppression, and reduce gastrointestinal reactions.