| Objective:The aim of this study was to assess short-term efficacy in patients with moderate-severe ulcerative colitis(UC)treated with Granulocyte and Monocyte Adsorption Apheresis(GMA)and Infliximab(IFX).Methods:23 patients with moderate-severe ulcerative colitis treated with GMA or IFX between January 2013 and February 2016 were enrolled from the First Affiliated Hospital of Dalian Medical University.In GMA group: 8 patients received intensive GMA(2/wk),total 5 sessions.In IFX group: 15 patients treated with infliximab(5mg/kg intravenously at week 0,2,6).According to the clinical manifestation and laboratory parameters,comparison of the efficacy of 5 GMA sessions and finished infliximab intravenously at week 0,2,6 was made;Evaluation the changes of erythrocyte sedimentation rate,c-reaction protein,hemoglobin,albumin was also carried out.Spss 20.0 software was used for the statistical analysis,p < 0.05 was considered to be of statistical significance.Result:1.General Data:There is no significantly statistical difference between the groups in gender,age,duration,Mayo score,the severity of coloscopy.In GMA group,male to female ratio is 1: 1.67;In IFX group,male to female ratio is 2: 1(p = 0.179).In GMA group:the average age of patients was 44.38 ± 11.6 years(31-60 years);In IFX group: the average age of patients was 38.47 ± 14.9 years(16-64 years)(p = 0.343).In GMA group: the average duration of patients was 58.8 ± 78m;In IFX group: the average duration of patients was 67.2 ± 88m(p = 0.860).In GMA group : Mayo score was 10.0 ± 0.92 points(9-11 points);In IFX group Mayo score was 10.27 ± 1.3(6-12points)(p = 0.621).Endoscopic score of GMA group was 2.88 ± 0.3 points,IFX group was 2.8 ± 0.4 points(p = 0.669).In GMA group : there were 3 moderate cases(37.5%)and 5 severe cases(62.5%);In IFX group : there were 8 moderate cases(53.3%)and 7severe cases(46.7%),(p = 0.667).2.Evaluation of efficacy of two treatment groups2.1 Clinical evaluationIn GMA group: 8 patients received 5 GMA sessions(2 times/wk).Clinical remission in 3 cases(42.85%),clinical response in 2 cases(28.57%),ineffective in 2cases,1 patient did not complete treatment.The total efficacy was 71.4%.In IFX group: 15 patients treated with infliximab(5mg/kg intravenously at week0,2,6).Clinical remission in 8 cases(53.3%),clinical response in 6 cases(40.0%),ineffective in 1 case.The total efficacy was 93.3%.2.2 The comparison of laboratory tests before and after GMA/IFX treatmentIn GMA group: There is no significantly statistical difference in ESR(t=1.320,p=0.257,p>0.05),CRP(t=1.564,p=0.193,p>0.05),ALB(t=-0.923,p=0.408,p>0.05),Hb(t=-0.409,p=0.703,p>0.05)UC patients before and after treatment.In IFX group: There is a significantly statistical difference in ESR(t=2.326,p= 0.037,p<0.05),CRP(t=2.651,p=0.020,p<0.05),ALB(t=-5.008,p=0.000,p<0.05),Hb(t=-0.409,p=0.703,p>0.05)UC patients before and after treatment.2.3 Comparison of effects between GMA / IFX group(after treatment)There is no significantly statistical difference between the two groups of the tatol clinical effective rate(p=0.227).There is also no significantly statistical difference in Hb(t=-0.941,p=0.36,p>0.05),ALB(t=-1.574,p=0.134,p>0.05),ESR(t=-0.306,p=0.763,p>0.05),CRP(t=-1.221,p=0.328,p>0.05)of the two gruops.2.4 Extraintestinal manifestations treatmentIn GMA group,the extraintestinal manifestations of two UC patients were not improved atfer GMA treatment.In IFX group,extraintestinal symptoms of two UC patients were improved after IFX treatment.2.5 Adverse reactionsNo serious adverse events occurred during GMA or IFX short-term remission induction therapy.Allergic reaction was found in only one patient of the IFX group.One patient of the GMA group appeared dizzy and chest tightness at the first GMA treatment.Conclusion : 1.Infliximab is effective in inducing short-term remission in moderate-severe active ulcerative colitis patients.2.GMA and IFX had similar short-term effects on remission induction in patients with moderate-severe active ulcerative colitis,GMA is an alternative treatment for moderate-severely active UC,and its long-term efficacy needs further observation. |
PDF Full Text Request