2025 年第 6 期 第 20 卷

肠内营养联合生物制剂在成人克罗恩病中的疗效分析

Efficacy analysis of enteral nutrition combined with biological agents in adult Crohn′s disease

作者：阳文俊1李息友1梁世伟1姚莉2

英文作者：Yang Wenjun1 Li Xiyou1 Liang Shiwei1 Yao Li2

单位：1桂林医学院第二附属医院消化内科，桂林541000；2广西医科大学第二附属医院消化内科，南宁530005

英文单位：1Department of Gastroenterology the Second Affiliated Hospital of Guilin Medical College Guilin 541000 China; 2Department of Gastroenterology the Second Affiliated Hospital of Guangxi Medical University Nanning 530005 China

关键词：克罗恩病；肠内营养；生物制剂

英文关键词：Crohn′sdisease;Enteralnutrition;Biologicalagents

• 摘要：

• 目的 探讨肠内营养联合生物制剂（英夫利昔单抗或乌司奴单抗）在成人中重度克罗恩病诱导缓解治疗中的效果及安全性。方法 回顾性选取桂林医学院第二附属医院及广西医科大学第二附属医院2018年10月至2024年10月确诊的克罗恩病患者的临床资料，根据是否联合肠内营养分为观察组（14例）和对照组（15例）。观察组予肠内营养+生物制剂治疗，对照组予少渣饮食+生物制剂治疗。比较2组一般临床资料、治疗前后实验室指标、体重指数及克罗恩病活动指数评分（CDAI）评估疾病活动度，记录不良反应发生情况。结果 治疗后，2组体重指数、白蛋白水平均高于治疗前，且观察组高于对照组［体重指数：（21.2±2.1）kg/m2比（19.3±2.9）kg/m2］，2组红细胞沉降率及CDAI均低于治疗前，且观察组均低于对照组（均P＜0.05）。所有患者均出现临床应答。观察组临床缓解12例（85.7%），对照组11例（73.3%），差异无统计学意义（χ2=0.132，P=0.716）。治疗期间，2组不良反应发生率比较差异无统计学意义（P>0.05）。结论 肠内营养联合生物制剂有利于诱导成人中重度克罗恩病缓解，且具有良好的安全性。

• Objective To investigate the efficacy and safety of enteral nutrition combined with biological agents (infliximab or ustekinumab) in the induction of remission in adults with moderate to severe Crohn′s disease. Methods The clinical data of Crohn′s disease patients diagnosed in the Second Affiliated Hospital of Guilin Medical College and the Second Affiliated Hospital of Guangxi Medical University from October 2018 to October 2024 were retrospectively selected. They were divided into observation group (14 cases) and control group (15 cases) according to whether they were combined with enteral nutrition. The observation group was treated with enteral nutrition and biological agents, and the control group was treated with less residue diet and biological agents. The general clinical data, laboratory indexes before and after treatment, body mass index and Crohn′s disease activity index (CDAI) score were compared between the two groups to evaluate the disease activity, and the occurrence of adverse reactions was recorded. Results After treatment, the body mass index and albumin level of the two groups were higher than those before treatment, and those of the observation group were higher than those of the control group ［body mass index: (21.2±2.1)kg/m2 vs (19.3±2.9)kg/m2］, and the erythrocyte sedimentation rate and CDAI of the two groups were lower than those before treatment, and those of the observation group were lower than those of the control group (all P<0.05). All patients had a clinical response. There were 12 cases (85.7%) of clinical remission in the observation group and 11 cases (73.3%) in the control group (χ2=0.132, P=0.716). During the treatment, there was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion Enteral nutrition combined with biological agents is beneficial to induce remission of moderate to severe Crohn′s disease in adults with good safety.