【摘要】 目的：探讨活动性克罗恩病患者接受维得利珠单抗治疗后缓解效果的影响因素并构建相关预测模型，为维得利珠单抗的临床应用及预后不良人群的早期识别提供更多信息。方法：回顾性选取2021年6月～2023年6月期间于某院接受维得利珠单抗治疗的91例活动性克罗恩病患者作为研究对象，根据治疗后是否达到临床缓解分为缓解组（n=81）和未缓解组（n=10）。组间临床资料进行单因素及多因素分析，得出缓解效果的独立影响因素；构建预测模型，并利用受试者工作特征（ROC）评估预测模型的效能。结果：活动性克罗恩病患者接受维得利珠单抗治疗14周后的临床缓解率为89.01%(81/91)。单因素分析结果显示，治疗后两组患者肛周累及比例、疾病类型及既往治疗史比较具有统计学差异（P<0.05）。多因素Logistic回归分析结果显示，是否累及肛周、疾病类型及既往治疗史均为活动性克罗恩病患者接受维得利珠单抗治疗后缓解效果的独立影响因素（P<0.05）。利用多因素Logistic回归分析的独立影响因素以及回归模型的P值预测概率对活动性克罗恩病患者接受维得利珠单抗治疗后的缓解效果进行预测，约登指数分别为46.30%（疾病类型）、71.60%（肛周累及）、35.19%（既往治疗情况）、84.57%（回归模型的P值预测概率）。结论：活动性克罗恩病患者接受维得利珠单抗治疗后的缓解效果可能与肛周累及情况、疾病类型及既往治疗史有关，利用以上因素构建的数据模型对于患者缓解效果的预测显示出良好效能，值得在工作中深入分析。更多还原

【Abstract】 Objective: To investigate the factors influencing remission in patients with active Crohn’s disease after treatment with vedolizumab and to develop prediction model, so as to provide more information for clinical application of vedolizumab and early identification of population at risk of poor prognosis. Methods: A total of 91 patients with active Crohn’s disease treated with vedolizumab in a hospital from June 2021 to June 2023 were selected retrospectively and assigned to the remission group(n=81) and non-remission group(n=10) based on the achievement of clinical remission following treatment. Univariate and multivariate analyses of clinical data between groups were conducted to identify independent factors influencing remission. A prediction model was then developed, and its performance was evaluated using receiver operating characteristic(ROC)analysis. Results: The clinical remission rate in patients with active Crohn’s disease after 14 weeks of treatment with vedolizumab was 89.01%(81/91). Univariate analysis showed that there were statistically significant differences in the proportion of perianal involvement, disease type and prior treatment history between the two groups after treatment(P<0.05). Multivariate Logistic regression analysis showed that perianal involvement, disease type and prior treatment history were independent factors influencing remission after treatment with vedolizumab in patients with active Crohn’s disease(P<0.05). The independent influencing factors by multivariate Logistic regression analysis and the P-value prediction probability of the regression model were used to predict the remission in patients with active Crohn’s disease after treatment with vedolizumab. The Youden index values were 46.30%(disease type), 71.60%(perianal involvement), 35.19%(prior treatment history) and 84.57%(P-value prediction probability of the regression model). Conclusion: The remission of patients with active Crohn’s disease after treatment with vedolizumab may be related to perianal involvement, disease type and prior treatment history, and the data model developed using the above factors showed good efficacy for predicting the remission of patients and is worth further analysis in clinical practice.更多还原