Value of transabdominal intestinal ultrasound in monitoring the efficacy of anti-tumor necrosis factor-α therapy for Crohn′s disease with intestinal fistula
10.3760/cma.j.cn131148-20240711-00371
- VernacularTitle:经腹部肠道超声监测抗肿瘤坏死因子α对克罗恩病合并肠瘘疗效的应用价值
- Author:
Lihua YAN
1
;
Xiaodong LUO
;
Shuochun CHEN
;
Yingjia LI
Author Information
1. 南方医科大学南方医院超声医学科，广州 510515
- Publication Type:Journal Article
- Keywords:
Ultrasonography, intestinal, transabdominal;
Crohn′s disease;
Enteric fistulas;
Tumor necrosis factor-α
- From:
Chinese Journal of Ultrasonography
2024;33(12):1050-1055
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe the application value of transabdominal intestinal ultrasound in monitoring the efficacy of anti-tumor necrosis factor-α (TNF-α) therapy in Crohn′s disease patients with enteric fistulas.Methods:A retrospective analysis was performed on 54 patients with Crohn′s disease complicated by enteric fistulas, who were treated with anti-TNF-α therapy at Nanfang Hospital, Southern Medical University from April 2020 to April 2024. Based on treatment outcomes, the patients were categorized into responder group and non-responder group.Intestinal ultrasound parameters were collected at baseline, at the end of induction therapy, and at 3 and 6 months of maintenance therapy. The changes in intestinal ultrasound parameters during anti-TNF-α treatment were analyzed and compared between the responder and non-responder groups at these time points.Results:After a 6-month follow-up, among the 54 patients, 39 patients were classified as clinical responders and 15 as clinical non-responders, resulting in a disease control rate of 72.22% (39/54) for anti-TNF-α therapy. In the responder group, significant improvements were observed in bowel wall thickness, layering, and the length of perienteric cellulitis or abscesses at the end of induction therapy, and at 3 and 6 months of maintenance therapy compared to baseline (all P<0.05). Additionally, the Limberg grading of bowel wall blood supply also showed significant improvement at 3 and 6 months of maintenance therapy compared to baseline (all P<0.05). Perienteric fat tissue edema showed significant improvement at 6 months of maintenance therapy compared to baseline ( P<0.05). Moreover, 28.21% (11/39) patients in the responder group achieved fistula healing after 6 months of maintenance therapy. In the non-responder group, there were no statistically significant differences in the aforementioned ultrasound parameters at any time point during the observation period (all P>0.05). Conclusions:Intestinal ultrasound can accurately reflect the changes in disease status in Crohn′s disease patients with enteric fistulas undergoing anti-TNF-α therapy, and it may be a reliable method for monitoring drug efficacy.
