背景：一些克罗恩病（Crohn's disease，CD）患者存在对英夫利昔单抗（infliximab，IFX）治疗反应丧失的情况。与正常人相比，CD患者的脾脏体积报告有增大。脾脏体积与CD中IFX疗效的关联尚不清楚。方法：我们对中山医院、复旦大学的CD患者进行了一项回顾性研究，这些患者在2015年8月至2021年12月期间接受了定期的IFX治疗。我们从中山医院的CD数据库中收集了基线特征和临床特点的医疗记录。我们使用半自动脾脏分割软件精确测量了脾脏体积，并对脾脏体积与IFX疗效进行了分析。结果：我们纳入了49名接受IFX治疗的CD患者，其中41名对IFX有反应，8名对IFX无反应。与治疗前相比，对IFX有反应的患者的脾脏体积，以及体质指数校正后的体积（SV/BMI）和体重校正后的体积（SV/W），在IFX治疗后显著减小，而对IFX无反应的患者脾脏体积增大。相应地，对IFX有反应的患者在IFX治疗后，白细胞计数、血小板计数、C-反应蛋白（CRP）和红细胞沉降率（ESR）水平减少。相反，对IFX治疗有反应的患者血红蛋白、白蛋白和肿瘤坏死因子（TNF）-α水平增高。此外，CRP和TNF-α水平与所有患者的SV/BMI显著正相关。结论：CD患者对IFX有反应后，脾脏体积，特别是SV/BMI和SV/W，减小。SV/BMI与疾病活动呈显著正相关。脾脏体积是评估CD中IFX疗效的有前景的指标。版权所有 © 2023 Shi、Wang、Rao、Liu和Wu。

Background: A number of patients with Crohn's disease (CD) suffer from loss of response to infliximab (IFX) therapy. Splenic volume is reported to be enlarged in patients with CD compared to normal individuals. The association between splenic volume and IFX efficacy in CD remains unclear. Methods: We performed a retrospective study of patients with CD who received regular IFX treatment at Zhongshan Hospital, Fudan University, between August 2015 and December 2021. We collected baseline characteristics and clinical features from medical records in the CD database of Zhongshan Hospital. We accurately measured the splenic volume using semi-auto spleen segmentation software, followed by the analysis of splenic volume and IFX efficacy. Results: We included 49 patients with CD receiving IFX treatment, of whom 41 responded to IFX and 8 failed to respond to IFX. Splenic volume, as well as volume adjusted for body mass index (SV/BMI) and body weight (SV/W), was significantly decreased after IFX treatment in responders but increased in non-responders compared to the volume before the treatment. Accordingly, the levels of leukocyte count, platelet count, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were decreased after IFX treatment in responders. Contrarily, the levels of hemoglobin, albumin, and tumor necrosis factor (TNF)-α were elevated in responders. Moreover, both CRP and TNF-α levels were significantly positively correlated with SV/BMI in all patients. Conclusion: Splenic volume, especially SV/BMI and SV/W, was reduced after IFX treatment in CD patients responsive to IFX. SV/BMI was positively correlated with disease activity. Splenic volume is a promising indicator to evaluate IFX efficacy in CD.Copyright © 2023 Shi, Wang, Rao, Liu and Wu.