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浙江大学学报（医学版）
浙江大学学报（医学版）  2016, Vol. 45 Issue (1): 81-85    DOI: 10.3785/j.issn.1008-9292.2016.01.13
原著     
血小板计数可预测英夫利昔单克隆抗体治疗活动性克罗恩病的疗效
沈海燕1,2, 徐承富1, 陈春晓1
1. 浙江大学医学院附属第一医院消化内科, 浙江 杭州 310003;
2. 嘉兴学院医学院附属第二医院消化内科, 浙江 嘉兴 314000
Platelet count predicts therapeutic response of infliximab for active Crohn's disease
SHEN Haiyan1,2, XU Chengfu1, CHEN Chunxiao1
1. Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China;
2. Department of Gastroenterology, the Second Affiliated Hospital, School of Medicine, Jiaxing College, Jiaxing 314000, China
全文: PDF(826 KB)  
摘要: 

目的:分析血小板计数预测英夫利昔单克隆抗体(IFX)治疗活动性克罗恩病疗效的价值。方法:收集2011年1月至2015年6月在浙江大学医学院附属第一医院消化内科确诊并接受IFX规律治疗的克罗恩病患者74例,其中男性50例,女性24例,诊断时年龄中位数21岁,病程中位数10个月。在开始治疗前和第三次、第六次治疗后检测患者血常规、血沉、C反应蛋白等指标,并评估克罗恩病活动指数。结果:IFX治疗三次后,患者克罗恩病活动指数以及白细胞计数、血小板计数、血沉、C反应蛋白均较治疗前减少(均P<0.01),血红蛋白和血细胞容积增加(均P<0.01);第六次治疗后上述指标比第三次治疗后进一步改善。共53例患者经三次治疗后达到临床缓解(克罗恩病活动指数<150);进一步分析发现,患者治疗前血小板计数与克罗恩病严重程度相关,且病程较长、治疗前克罗恩病活动指数和血小板计数较大的患者IFX治疗三次后不易缓解。结论:克罗恩病患者血小板计数与疾病严重程度相关,且可作为预测IFX早期疗效的指标。
关键词 ： Crohn病/治疗,  抗体,单克隆/治疗应用,  血小板计数,  治疗结果,  预测    
Abstract：

Objective: To explore the platelet count in prediction of the efficacy of infliximab for active Crohn's disease. Methods: A total of 74 patients with Crohn's disease, including 50 males and 24 females with mean age of 27 years, receiving infliximab therapy from January 2011 to June 2015 were retrospectively included. Clinical variables including routine blood test, erythrocyte sedimentation rate, C-reactive protein and Crohn's disease activity index were measured before treatment and after 3rd, 6th treatments. Results: Compared with baseline, the Crohn's disease activity index score, white blood cell count, platelet count, erythrocyte sedimentation rate, C-reactive protein significantly decreased (all P<0.01), while hemoglobin and red blood cell hematocrit increased (P<0.01) in patients after 3 treatments of infliximab. These variables were further improved after 6 treatments. Further analysis showed that platelet count was positively associated with disease severity of Crohn's disease. Fifty-three patients achieved clinical remission (Crohn's disease activity index score < 150) after 3 treatments of infliximab. Logistic regression analysis showed that baseline platelet count, Crohn's disease activity index, and disease course were three predictors for clinical remission of Crohn's disease. Conclusion: Platelet count is positively associated with disease severity of Crohn's disease, and baseline platelet count is an important predicator for the early response of infliximab therapy.
Key words： Crohn disease/therapy    Antibodies, monoclonal/therapeutic use    Platelet count    Treatment outcome    Forecasting
收稿日期: 2015-10-15     
CLC:  R574.62  
基金资助:

国家自然科学基金(81273536)
通讯作者: 陈春晓(1962-),女,硕士,主任医师,主要从事小肠疾病诊治研究;E-mail:13906523922@126.com;http://orcid.org/0000-0001-7536-1191     E-mail: 13906523922@126.com
作者简介: 沈海燕(1980-),女,学士,副主任医师,主要从事小肠疾病诊治研究;E-mail:shymaomao1980@163.com;http://orcid.org/0000-0002-7427-8107
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引用本文:

沈海燕 等. 血小板计数可预测英夫利昔单克隆抗体治疗活动性克罗恩病的疗效[J]. 浙江大学学报（医学版）, 2016, 45(1): 81-85.
SHEN Haiyan, XU Chengfu, CHEN Chunxiao. Platelet count predicts therapeutic response of infliximab for active Crohn's disease. Journal of ZheJiang University(Medical Science), 2016, 45(1): 81-85.

链接本文:

http://www.zjujournals.com/xueshu/med/CN/10.3785/j.issn.1008-9292.2016.01.13      或      http://www.zjujournals.com/xueshu/med/CN/Y2016/V45/I1/81

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