Dynamic Study of Effect of Low Dose Infliximab in Ankylosing Spondylitis

作     者：Deepa Shah 

作者单位：吉林大学 

学位级别：硕士

导师姓名：Bi Li Qi

授予年度：2013年

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

摘      要：Objectives: To study the effect of low dose infliximab in patients with ankylosing spondylitis（AS） in3different aspects simultaneously. The first is clinical disease activity of AS measuredby Bath Ankylosing Spondylitis Disease Activity Index （BASDAI） and Bath AnkylosingSpondylitis Metrology Index （BASMI）, the second is its relationship with routine laboratoryparameters predicting the disease activity, like Erythrocyte Sedimentation Rate （ESR）, C-reactive protein （CRP）, platelet etc and the third is serum level of cytokines like TNF-α and IL-6. Method: Thirty-four patients with AS treated with infliximab were included in this longitudinalcohort study. All patients fulfilled the modified New York criteria for AS. Low dose infliximabwas given intravenously （3mg/kg body weight） at0,2,6and every8weeks thereafter for aperiod of22weeks. Clinical disease activity was assessed by BASDAI score and BASMI scoreand clinical improvement was recorded according to Bath Ankylosing Spondylitis DiseaseActivity Index20%（BASDAI20）, Bath Ankylosing Spondylitis Disease Activity Index50%（BASDAI50） and Bath Ankylosing Spondylitis Disease Activity Index70%（BASDAI70）.Laboratory measures like ESR, CRP, total platelet count and serum albumin were recorded ateach visit. Serum TNF-α level and IL-6were analyzed in13patients for4visits. Radiologicalassessment was done by computed tomography （CT） scan of sacro-iliac joint before the patientstarted therapy. Therapeutic safety of the drug was monitored at each visit by assessing completeblood count, liver function test and renal function test. Result: Thirty-four patients were enrolled in the study. The mean age of the patients was32.5years and mean weight was72.2kg.88.2%of the patients were male and11.8%patients werefemale.41.2%（14/34） of the patients were smoker. All the patients tested positive for *** scan of sacro-iliac joint revealed33.3%patients with grade IV sacroiliitis bilaterally,48.5%patients with grade III sacroiliitis bilat