血清低免疫球蛋白G对评价溃疡性结肠炎疾病严重程度的价值
摘要
目的探讨血清低免疫球蛋白G(IgG)水平在评估溃疡性结肠炎(UC)疾病严重程度中的价值。方法对2015年1月至2018年4月住院确诊的117例UC患者进行回顾性分析。所有患者入院24 h内检测血清IgG水平,将IgG <7 g/L者纳为低IgG组,将IgG 7～17 g/L者纳为正常IgG组。对比两组一般资料、实验室检测指标、疾病活动度、合并症情况及治疗效果。结果 117例患者中,低IgG者26例(22. 22%),正常IgG者91例(77. 78%)。与正常IgG组对比,疾病严重程度明显更高,巨细胞病毒(CMV)感染者明显更多,血清白蛋白水平明显更低、超敏C反应蛋白明显更高,对激素治疗方案的疗效更差,上述差异均有统计学意义(均P <0. 05)。结论 UC患者可能存在血清低IgG现象,这会增加患者机会感染及激素治疗失败风险,且可能导致患者临床症状更严重。
引文
[1]卫珮如,白杨,王继德.溃疡性结肠炎癌变监测的研究进展[J].现代消化及介入诊疗,2018,23(1):127-131.
[2]Da Silva BC,Lyra AC,Rocha R,et al.Epidemiology,demographic characteristics and prognostic predictors of ulcerative colitis[J].World J Gastroenterol,2014,20(28):9458-9467.
[3]Macdermott RP,Nash GS,Auer IO,et al.Alterations in ser3um immunoglobulin G subclasses in patients with ulcerative colitis and Crohn’s disease[J].Gastroenterology,1989,96(3):764-768.
[4]罗春艳,黄忠.美沙拉嗪联合培菲康对溃疡性结肠炎患者免疫功能及炎性因子的影响[J].国际消化病杂志,2017,37(1):41-44,70.
[5]Rai T,Wu X,Shen B.Frequency and risk factors of low immunoglobulin levels in patients with inflammatory bowel disease[J].Gastroenterol Rep(Oxf),2015,3(2):115-121.
[6]贾军义.围手术期应用重组人生长激素对肠梗阻患者肠黏膜屏障的保护作用及免疫炎症反应评估[J].海南医学院学报,2017,23(11):1509-1512.
[7]中华医学会消化病学分会炎症性肠病学组.炎症性肠病诊断与治疗的共识意见(2012年·广州)[J].胃肠病学,2012,17(12):763-781.
[8]Dignass A,Eliakim R,Magro F,et al.Second European evidence-based consensus on the diagnosis and management of ulcerative colitis part 1:definitions and diagnosis[J].J Crohns Colitis,2012,6(10):965-990.
[9]Satsangi J,Silverberg MS,Vermeire S,et al.The Montreal classification of inflammatory bowel disease:controversies,consensus,and implications[J].Gut,2006,55(6):749-753.
[10]Truelove SC,Witts LJ.Cortisone in ulcerative colitis;final report on a therapeutic trial[J].Br Med J,1955,2(4947):1041-1048.
[11]陈璐,周中银.溃疡性结肠炎发病机制的研究进展[J].疑难病杂志,2016,15(6):650-654.
[12]Gong Y,Lin Y,Zhao N,et al.The Th17/Treg Immune Imbalance in Ulcerative Colitis Disease in a Chinese Han Population[J].Mediators Inflamm,2016,2016:7089137.
[13]沈玲,邱海波,陈前波,等.神经病理性疼痛对溃疡性结肠炎大鼠肠道炎症变化及免疫球蛋白浓度的影响[J].临床麻醉学杂志,2017,33(6):592-594.
[14]李桢,徐华,周华友,等.ss DNA适配体阻断FcγR介导巨噬细胞吞噬作用的研究[J].中国输血杂志,2017,30(9):14-16.
[15]房志科,马新蕾,何景儿,等.“升脾方”对溃疡性结肠炎患者免疫功能影响的临床研究[J].江苏中医药,2016,48(7):40-41.
[16]Horton N,Wu X,Philpott J,et al.Impact of Low Immunoglobulin G Levels on Disease Outcomes in Patients with Inflammatory Bowel Diseases[J].Dig Dis Sci,2016,61(11):3270-3277.
[17]Horton N,Kochhar G,Patel K,et al.Efficacy and Factors Associated with Treatment Response of Intravenous Immunoglobulin in Inpatients with Refractory Inflammatory Bowel Diseases[J].Inflamm Bowel Dis,2017,23(7):1080-1087.
[18]Yomota M,Amano I,Horita N,et al.Serum immunoglobulin G is a marker for the risk of opportunistic infection in steroid-dependent severe asthmatic patients[J].Intern Med,2012,51(19):2715-2719.
[19]沈浩.溃疡性结肠炎患者免疫功能状态的临床研究[J].现代消化及介入诊疗,2016,21(4):554-556.
[20]王征,郑威扬,李骥,等.血清低Ig G与溃疡性结肠炎关系研究[J].中国实用内科杂志,2018,38(3):58-61.
[2]Da Silva BC,Lyra AC,Rocha R,et al.Epidemiology,demographic characteristics and prognostic predictors of ulcerative colitis[J].World J Gastroenterol,2014,20(28):9458-9467.
[3]Macdermott RP,Nash GS,Auer IO,et al.Alterations in ser3um immunoglobulin G subclasses in patients with ulcerative colitis and Crohn’s disease[J].Gastroenterology,1989,96(3):764-768.
[4]罗春艳,黄忠.美沙拉嗪联合培菲康对溃疡性结肠炎患者免疫功能及炎性因子的影响[J].国际消化病杂志,2017,37(1):41-44,70.
[5]Rai T,Wu X,Shen B.Frequency and risk factors of low immunoglobulin levels in patients with inflammatory bowel disease[J].Gastroenterol Rep(Oxf),2015,3(2):115-121.
[6]贾军义.围手术期应用重组人生长激素对肠梗阻患者肠黏膜屏障的保护作用及免疫炎症反应评估[J].海南医学院学报,2017,23(11):1509-1512.
[7]中华医学会消化病学分会炎症性肠病学组.炎症性肠病诊断与治疗的共识意见(2012年·广州)[J].胃肠病学,2012,17(12):763-781.
[8]Dignass A,Eliakim R,Magro F,et al.Second European evidence-based consensus on the diagnosis and management of ulcerative colitis part 1:definitions and diagnosis[J].J Crohns Colitis,2012,6(10):965-990.
[9]Satsangi J,Silverberg MS,Vermeire S,et al.The Montreal classification of inflammatory bowel disease:controversies,consensus,and implications[J].Gut,2006,55(6):749-753.
[10]Truelove SC,Witts LJ.Cortisone in ulcerative colitis;final report on a therapeutic trial[J].Br Med J,1955,2(4947):1041-1048.
[11]陈璐,周中银.溃疡性结肠炎发病机制的研究进展[J].疑难病杂志,2016,15(6):650-654.
[12]Gong Y,Lin Y,Zhao N,et al.The Th17/Treg Immune Imbalance in Ulcerative Colitis Disease in a Chinese Han Population[J].Mediators Inflamm,2016,2016:7089137.
[13]沈玲,邱海波,陈前波,等.神经病理性疼痛对溃疡性结肠炎大鼠肠道炎症变化及免疫球蛋白浓度的影响[J].临床麻醉学杂志,2017,33(6):592-594.
[14]李桢,徐华,周华友,等.ss DNA适配体阻断FcγR介导巨噬细胞吞噬作用的研究[J].中国输血杂志,2017,30(9):14-16.
[15]房志科,马新蕾,何景儿,等.“升脾方”对溃疡性结肠炎患者免疫功能影响的临床研究[J].江苏中医药,2016,48(7):40-41.
[16]Horton N,Wu X,Philpott J,et al.Impact of Low Immunoglobulin G Levels on Disease Outcomes in Patients with Inflammatory Bowel Diseases[J].Dig Dis Sci,2016,61(11):3270-3277.
[17]Horton N,Kochhar G,Patel K,et al.Efficacy and Factors Associated with Treatment Response of Intravenous Immunoglobulin in Inpatients with Refractory Inflammatory Bowel Diseases[J].Inflamm Bowel Dis,2017,23(7):1080-1087.
[18]Yomota M,Amano I,Horita N,et al.Serum immunoglobulin G is a marker for the risk of opportunistic infection in steroid-dependent severe asthmatic patients[J].Intern Med,2012,51(19):2715-2719.
[19]沈浩.溃疡性结肠炎患者免疫功能状态的临床研究[J].现代消化及介入诊疗,2016,21(4):554-556.
[20]王征,郑威扬,李骥,等.血清低Ig G与溃疡性结肠炎关系研究[J].中国实用内科杂志,2018,38(3):58-61.