[The application and therapeutic effects of immunodepressant for Crohn's disease]

To investigate the therapeutic effect of immunodepressant on Crohn's disease (CD).

105 patients with CD were collected from 1983 to 2006 in Peking Union Medical College Hospital. All of their clinical manifestations and therapeutic results were analyzed retrospectively.

(1) The application of immunodepressant was significantly increased after the year of 2000 (34.7% vs 3.0%, P = 0.000). (2) The application of immunodepressant and the clinical features of these patients were as follows: 1) The number of patients with moderate to severe CD were more than that with mild CD in those using immunodepressant (28.9% vs 0). 2) The use of immunodepressant was not related with the diseased site of CD, because there were no difference among the groups with lesion in small intestine (20.0%), colon (27.3%) and ileocolon (27.1%), P =0.726. 3) The serum albumin level of CD patients using immunodepressant was significantly lower than that of those not using (31.9 g/L vs 35.1 g/L, P = 0.047). 4) The use of immunodepressant did not decrease the incidence of operative treatment (38.5% vs 50.0%, P= 0.320). (3) The rate of remission in 19 CD patients using azathioprine is 68.4% (13/19) and the percentage of neutrophil in the group with relief was lower than that without relief (0.76 vs 0.65, P = 0.032).

Immunodepressant is playing more important role in the treatment of CD. The patients with moderate and severe CD with as well as lower serum albumin should be treated with immunodepressant as early as possible. Whether immunodepressant is necessary or not is not decided by the diseased site. CD patients with higher percentage of neutrophil have less therapeutic effect than those with lower.