Infliximab stopped severe gastrointestinal bleeding in Crohn's disease
Infliximab stopped severe gastrointestinal bleeding in Crohn's disease
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DOI：
10.3748/wjg.v18.i21.2730
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发表时间：
2012-06-07
影响因子：
4.3
通讯作者：
Rerknimitr, Rungsun
中科院分区：
文献类型：
--
作者：
Aniwan, Satimai;Eakpongpaisit, Surasak;Rerknimitr, Rungsun
报告英夫利西单抗治疗克罗恩病合并严重肠结肠出血患者溃疡快速愈合的结果。在2005年和2010年期间，审查了朱拉隆功国王纪念医院和三美泰医院的炎症性肠病数据库。有7例克罗恩病（CD）患者（4例女性和3例男性;平均年龄52 ± 10.4岁;范围：11-86岁）。7例患者中有2例发生严重胃肠道出血（GIB）作为CD的发作，而其他5例患者以GIB作为CD的首发症状。他们的平均血红蛋白水平在3天内从12 +/- 1.3 g/ dL下降到8.7 +/- 1.3 g/dL。复苏所需的中位红细胞压积单位为4个单位。由于无法控制的出血，考虑手术切除。然而，由于这些患者（n = 3）的手术候选资格较差和/或可能发生短肠综合征（n = 6），未进行手术。同样，由于大面积梗死的风险，未考虑血管造影栓塞。所有重度GIB均通过一次或两次静脉注射英夫利西单抗成功停止。我们的数据表明，当手术有限制或患者是一个高风险的CD与严重GIB的替代疗法。(C)2012年百世登。All rights reserved.
To report the result of rapid ulcer healing by infliximab in Crohn's patients with severe enterocolic bleeding. During 2005 and 2010, inflammatory bowel disease database of King Chulalongkorn Memorial and Samitivej hospitals were reviewed. There were seven Crohn's disease (CD) patients (4 women and 3 men; mean age 52 +/- 10.4 years; range: 11-86 years). Two of the seven patients developed severe gastrointestinal bleeding (GIB) as a flare up of CD whereas the other five patients presented with GIB as their first symptom for CD. Their mean hemoglobin level dropped from 12 +/- 1.3 g/ dL to 8.7 +/- 1.3 g/dL in a 3-d period. Median packed red blood cells units needed for resuscitation was 4 units. Because of uncontrolled bleeding, surgical resection was considered. However, due to the poor surgical candidacy of these patients (n = 3) and /or possible development of short bowel syndrome (n = 6), surgery was not pursued. Likewise angiographic embolization was not considered in any due to the risk of large infarction. All severe GIBs successfully stopped by one or two doses of intravenous infliximab. Our data suggests that influximab is an alternative therapy for CD with severe GIB when surgery has limitation or patient is a high risk. (C) 2012 Baishideng. All rights reserved.