免疫抑制剂联合生物制剂对炎症性肠病患者营养状况及炎症因子的影响
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摘要
目的分析免疫抑制剂联合生物制剂对炎症性肠病患者营养状况及炎症因子的影响。方法选择台州市第一人民医院2018年1—12月治疗的72例炎症性肠病患者,根据不同疗法将其纳入对照组与观察组各36例,对照组给予免疫抑制剂硫唑嘌呤治疗,观察组给予免疫抑制剂硫唑嘌呤联合生物制剂英夫利西单抗治疗,对比2组的临床疗效、营养状况、炎症因子以及不良反应情况。结果观察组总有效率(94.4%)高于对照组(77.8%),治疗后的血清白蛋白、转铁蛋白、前白蛋白、血红蛋白[(42.1±5.0)g/L、(2.8±0.5)g/L、(251.7±51.3)mg/L、(133.5±19.5)g/L]优于对照组[(36.9±5.2)g/L、(2.5±0.3)g/L、(232.4±44.8)mg/L、(120.4±10.7)g/L],治疗后的TNF-α、IL-4、IL-10、IL-17[(117.3±19.0)pg/L、(11.0±1.8)pg/L、(7.4±1.1)pg/L、(187.3±38.2)pg/L]优于对照组[(186.6±38.3)pg/L、(16.5±2.4)pg/L、(10.9±1.7)pg/L、(285.4±32.7)pg/L],差异均有统计学意义(均P<0.05)。观察组不良反应发生率(16.7%)与对照组(13.9%)相当,差异无统计学意义(P>0.05)。结论免疫抑制剂联合生物制剂对炎症性肠病患者的疗效显著,可明显改善患者的营养状况,降低炎症因子水平,且安全性高。
Objective To analyze the effects of immunosuppressive agents combined with biological agents on nutritional status and inflammatory factors in patients with inflammatory bowel disease. Methods Seventy-two patients with inflammatory bowel disease in our hospital from January to December 2018 were selected. According to different therapies, 36 patients in the control group and 36 patients in the observation group were included. The control group was treated with azathioprine, an immunosuppressant, and the observation group was treated with azathioprine combined with infliximab, a biological agent. The clinical efficacy, nutritional status, inflammatory factors and adverse reactions of the two groups were compared. Results The total effective rate of the observation group(94.4%) was higher than that of the control group(77.8%). After treatment, the serum albumin, transferrin, prealbumin and hemoglobin in the observation group [(42.1±5.0)g/L,(2.8±0.5)g/L,(251.7±51.3)mg/L,(133.5±19.5)g/L] were better than those in the control group [(36.9±5.2)g/L,(2.5±0.3)g/L,(232.4±44.8)mg/L,(120.4±10.7)g/L], TNF-alpha, IL-4, IL-10, IL-17 in the observation group [(117.3±19.0)pg/L,(11.0±1.8)pg/L,(7.4±1.1)pg/L,(187.3±38.2)pg/L] was superior to the control group [(186.6±38.3)pg/L,(16.5±2.4)pg/L,(10.9±1.7)pg/L,(285.4±32.7)pg/L]. There were significant differences among the groups(all P<0.05). The incidence of adverse reactions in the observation group(16.7%) was similar to that in the control group(13.9%). There was no significant difference between the two groups(P>0.05). Conclusion Immunosuppressive agents combined with biological agents are effective in the treatment of inflammatory bowel disease, which can significantly improve the nutritional status of patients and reduce the level of inflammatory factors, and high safety.
Objective To analyze the effects of immunosuppressive agents combined with biological agents on nutritional status and inflammatory factors in patients with inflammatory bowel disease. Methods Seventy-two patients with inflammatory bowel disease in our hospital from January to December 2018 were selected. According to different therapies, 36 patients in the control group and 36 patients in the observation group were included. The control group was treated with azathioprine, an immunosuppressant, and the observation group was treated with azathioprine combined with infliximab, a biological agent. The clinical efficacy, nutritional status, inflammatory factors and adverse reactions of the two groups were compared. Results The total effective rate of the observation group(94.4%) was higher than that of the control group(77.8%). After treatment, the serum albumin, transferrin, prealbumin and hemoglobin in the observation group [(42.1±5.0)g/L,(2.8±0.5)g/L,(251.7±51.3)mg/L,(133.5±19.5)g/L] were better than those in the control group [(36.9±5.2)g/L,(2.5±0.3)g/L,(232.4±44.8)mg/L,(120.4±10.7)g/L], TNF-alpha, IL-4, IL-10, IL-17 in the observation group [(117.3±19.0)pg/L,(11.0±1.8)pg/L,(7.4±1.1)pg/L,(187.3±38.2)pg/L] was superior to the control group [(186.6±38.3)pg/L,(16.5±2.4)pg/L,(10.9±1.7)pg/L,(285.4±32.7)pg/L]. There were significant differences among the groups(all P<0.05). The incidence of adverse reactions in the observation group(16.7%) was similar to that in the control group(13.9%). There was no significant difference between the two groups(P>0.05). Conclusion Immunosuppressive agents combined with biological agents are effective in the treatment of inflammatory bowel disease, which can significantly improve the nutritional status of patients and reduce the level of inflammatory factors, and high safety.
引文
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[9] 米晓强,张雪梅,李爱华,等.英夫利西单抗联合硫唑嘌呤治疗中重度溃疡性结肠炎的临床价值分析[J].解放军预防医学杂志,2016,34(S2):207-208.
[10] 田丰,解莹,闫博.早期应用英夫利昔单抗联合硫唑嘌呤治疗合并2个以上预后不良高危因素克罗恩病疗效及安全性研究[J].中国实用内科杂志,2017,37(3):242-246.
[11] 陈建林,陈锦锋,邓健敏,等.硫唑嘌呤合加味愈疡汤对激素依赖型溃疡性结肠炎患者激素替代的临床研究[J].中国中西医结合消化杂志,2016,24(4):287-289.
[12] 孙俊,王宏志,汪毅,等.英夫利西单抗联合自拟行气活血汤保留灌肠对中重度小肠克罗恩病患者免疫及凝血功能的影响[J].现代中西医结合杂志,2018,27(13):435-436.
[13] 杨俊,金玉,潘迪,等.英夫利昔单抗治疗溃疡性结肠炎的效果及对炎症因子水平的影响[J].中国医药导报,2017,14(15):148-151.
[14] 兰雨桐,刘威宇,邢俊伟,等.英夫利西单抗治疗中重度活动性克罗恩病的疗效及安全性[J].中国医科大学学报,2018,47(4):333-337.
[15] 邵晓晓,曹佳乐,俞玲敏,等.英夫利西单抗联合肠内营养在中重度溃疡性结肠炎治疗中的临床价值[J].温州医科大学学报,2018,48(9):684-687.
[16] 简春宣,舒慧.英夫利昔单抗联合不同免疫抑制剂治疗溃疡性结肠炎的疗效比较[J].结直肠肛门外科,2016,22(5):506-509.
[17] 陆蔚,张苏闽.英夫利昔单抗联合硫唑嘌呤对克罗恩病肛瘘手术患者血清炎性因子及免疫功能的影响[J].实用医院临床杂志,2018,15(3):229-231.
[18] 尧小青,金瑞放,苏林燕.英夫利西单抗治疗小肠克罗恩病患者临床疗效观察及对患者黏膜愈合和血清实验指标影响[J].中国中西医结合消化杂志,2018,26(5):392-395.
[19] 林海,姚国和,李强,等.硫唑嘌呤治疗激素依赖溃疡性结肠炎的IL-8、TNF-α水平的临床研究[J].齐齐哈尔医学院学报,2017,38(2):59-60.
[20] 刘芳,李靖涛,宋振梅,等.英夫利昔单抗联合硫唑嘌呤对克罗恩病患者免疫功能和细胞因子的影响[J].中华全科医学,2017,15(4):586-588.
[2] 王晖,黄海涛,梁三红,等.英夫利西单抗联合硫唑嘌呤片对炎症性肠病患者T淋巴细胞的影响[J].实用药物与临床,2017,20(9):1039-1042.
[3] 陈白莉,钱家鸣,吴开春,等.英夫利西治疗活动性溃疡性结肠炎疗效与安全性的临床研究[J].中华炎性肠病杂志:中英文,2017,1(1):20-23.
[4] 朱振浩,邱琛,张明,等.英夫利西单抗治疗的小肠克罗恩病患者不同肠段黏膜愈合情况分析[J].南方医科大学学报,2017,37(1):44-48.
[5] 欧阳钦,潘国宗,温忠慧,等.对炎症性肠病诊断治疗规范的建议[J].中华内科杂志,2001,40(2):138-141.
[6] 杨敬貌,吴小丽,陈丽萍,等.早期应用英夫利昔联合免疫抑制剂治疗中重度克罗恩病的疗效观察[J].临床内科杂志,2017,34(3):169-172.
[7] 刘爱玲,吕红,杨红,等.英夫利西单抗在急性重度溃疡性结肠炎拯救治疗中的疗效分析[J].胃肠病学,2017,22(10):604-609.
[8] 苏林燕,尧小青.英夫利西单抗辅助治疗成人克罗恩病临床疗效及对生存质量的影响[J].浙江中西医结合杂志,2018,28(5):37-39.
[9] 米晓强,张雪梅,李爱华,等.英夫利西单抗联合硫唑嘌呤治疗中重度溃疡性结肠炎的临床价值分析[J].解放军预防医学杂志,2016,34(S2):207-208.
[10] 田丰,解莹,闫博.早期应用英夫利昔单抗联合硫唑嘌呤治疗合并2个以上预后不良高危因素克罗恩病疗效及安全性研究[J].中国实用内科杂志,2017,37(3):242-246.
[11] 陈建林,陈锦锋,邓健敏,等.硫唑嘌呤合加味愈疡汤对激素依赖型溃疡性结肠炎患者激素替代的临床研究[J].中国中西医结合消化杂志,2016,24(4):287-289.
[12] 孙俊,王宏志,汪毅,等.英夫利西单抗联合自拟行气活血汤保留灌肠对中重度小肠克罗恩病患者免疫及凝血功能的影响[J].现代中西医结合杂志,2018,27(13):435-436.
[13] 杨俊,金玉,潘迪,等.英夫利昔单抗治疗溃疡性结肠炎的效果及对炎症因子水平的影响[J].中国医药导报,2017,14(15):148-151.
[14] 兰雨桐,刘威宇,邢俊伟,等.英夫利西单抗治疗中重度活动性克罗恩病的疗效及安全性[J].中国医科大学学报,2018,47(4):333-337.
[15] 邵晓晓,曹佳乐,俞玲敏,等.英夫利西单抗联合肠内营养在中重度溃疡性结肠炎治疗中的临床价值[J].温州医科大学学报,2018,48(9):684-687.
[16] 简春宣,舒慧.英夫利昔单抗联合不同免疫抑制剂治疗溃疡性结肠炎的疗效比较[J].结直肠肛门外科,2016,22(5):506-509.
[17] 陆蔚,张苏闽.英夫利昔单抗联合硫唑嘌呤对克罗恩病肛瘘手术患者血清炎性因子及免疫功能的影响[J].实用医院临床杂志,2018,15(3):229-231.
[18] 尧小青,金瑞放,苏林燕.英夫利西单抗治疗小肠克罗恩病患者临床疗效观察及对患者黏膜愈合和血清实验指标影响[J].中国中西医结合消化杂志,2018,26(5):392-395.
[19] 林海,姚国和,李强,等.硫唑嘌呤治疗激素依赖溃疡性结肠炎的IL-8、TNF-α水平的临床研究[J].齐齐哈尔医学院学报,2017,38(2):59-60.
[20] 刘芳,李靖涛,宋振梅,等.英夫利昔单抗联合硫唑嘌呤对克罗恩病患者免疫功能和细胞因子的影响[J].中华全科医学,2017,15(4):586-588.
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