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目的：评价英夫利西单抗辅助治疗克罗恩病伴不全性肠梗阻患者中的疗效和安全性。方法：选择22罗恩病伴有不全性肠梗阻的患者，将其随机分为英夫利西单抗治疗组及常规治疗组。常规治疗组患者予禁食或流质饮食、抗感染、补液维持水电平衡等内科常规治疗，并予美沙拉嗪、强的松、硫唑嘌呤长期口服。英夫利昔单抗治疗组在常规治疗的基础上，在治疗第0、2、6、14、22、30 周给予英夫利西单抗5mg/kg。治疗30 周时，检查和比较2 组患者治疗前后的血象、肝功能、血沉、C 反应蛋白、记录CD疾病活动指数，行肠镜检查评价疗效。并记录治疗期间患者不良反应的发生情况。结果：治疗第30 周末，英夫利昔单抗治疗组的临床总有效率和内镜下总有效率均显著高于常规治疗组(P<0.05)；且英夫利昔单抗治疗组血沉和CRP水平、CDAI较第0 周均显著降低 (P<0.05)。治疗期间英夫利昔单抗治疗组无严重不良反应发生。结论：在内科常规常规保守治疗的基础上，给予英夫利昔单抗辅助治疗可显著提高CD伴有不全性肠梗阻患者的疗效。

英文摘要:

Objective:To evaluate the efficacy and safety of Infliximab in adjuvant treatment of Crohn's disease complicated by incomplete intestinal obstruction.Methods:22 patients with Crohn's disease complicated with incomplete intestinal obstruction were enrolled, which were divided into 2 groups randomly, named GROUP Infliximab (GI) and GROUP Conserve (GC). Patients in GC were treated with fasting or liquid drinks, anti-inflammation, fluid resuscitation, water, electrolyte and acid-base balancing, and were received long-term oral medicine as mesalazine, prednisone and azathioprine. Patients in GI were treated with the same medicine as patients in GC, but added with Infliximab (5mg.kg) in week 0, 2, 6, 14, 22, 30. Each group was undertaken blood picture、hepatic function、 erythrocyte sedimentation rate(ESR),C-reactive protein(CRP), and Crohn's disease activity index(CDAI) was recorded in week 0 and 30. All indexes were compared before and after treatment. All the patients underwent a colonoscopy in week 0 and 30 to evaluate the therapeutic effect. Adverse reactions of medicine were recorded during therapeutic term.Results:At the end of 30th week, the total clinical effective rate and endoscopic effective rate in GI were higher than those in GC (P<0.05). The level of ESR,CRP and CDAI in GI were decreased significantly than those at week 0 (P<0.05). No severe adverse reactions was encountered during all the therapeutic term.Conclusion:Based on treating in conventional manner, adjuvant treating with Infliximab can improve the curative effect of Crohn's disease complicated by incomplete intestinal obstruction.

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