Abstract:Objective To investigate the effects of Infliximab in the treatment of ulcerative colitis and its influence on the levels of inflammatory factors. Methods Two hundred and forty patients with moderate ulcerative colitis treated in Shengjing Hospital Affiliated to China Medical University from July 2013 to October 2015 were selected and randomly divided into observation group and control group, with 120 cases in each group. The control group was given routine drug Azathioprine, on basis of which, the observation group was added with Infliximab, continuous treatment for 30 d. The clinical efficacy of the two groups was observed, and the levels of serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), albumin (Alb) hemoglobin (Hb) and inflammatory factors before and after treatment between the two groups were compared. Results The total effective rate of observation group (80.83%) was significantly higher than that of the control group (61.67%), the difference was statistically significant (P < 0.05). After treatment, the levels of CRP, ESR, Alb, Hb in the two groups were all improved compared with those before treatment, the differences were all statistically significant (P < 0.05), and the levels of CRP and ESR in the observation group were lower than those of the control group, while the levels of Alb and Hb were higher than those of the control group, the differences were all statistically significant (P < 0.05). The levels of interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-23 (IL-23) and tumor necrosis factor alpha (TNF-α) in the two groups after treatment were all significantly lower than those before treatment, the differences were statistically significant (P < 0.05), and the levels of IL-6, IL-8, IL-23 and TNF-α in the observation group after treatment were lower than those of control group, there were statistically significant differences (P < 0.05). Conclusion Infliximab in the treatment of severe ulcerative colitis has exact effects, which can effectively improve the patient's intestinal mucosa, and it has important significance for decreasing the level of inflammatory factors, it is conducive for the prognosis of patients and worthy of clinical promotion and application.
杨俊 金玉 潘迪 王东旭 林艳 郑长青. 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.
YANG Jun JIN Yu PAN Di WANG Dongxu LIN Yan ZHENG Changqing. Effect of Infliximab in the treatment of ulcerative colitis and its influence on the levels of inflammatory factors. 中国医药导报, 2017, 14(15): 148-151.
[1] Sciaudone G,Pellino G,Guadagni I,et al. Education and imaging: gastrointestinal: herpes simplex virus-associated erythema multiforme(HAEM)during infliximab treatment for ulcerative colitis [J]. J Gastraenterd Hepatol,2011,26(3):610.
[2] 吴建新,张敏红,陈源文,等肿瘤坏死因子拮抗疗法对暴发型溃疡性结肠炎诱导缓解的初步探讨[J].中华消化杂志,2010,30(2):87-89.
[3] 张雷,鞠大闯,刘庭惠,等.复方纳米银抗菌水凝胶对溃疡性结肠炎大鼠肠道屏障功能的影响[J].现代医院,2016, 16(5):644-646.
[4] 梁洁,周林,沙素梅,等.炎症性肠病诊断与治疗的共识意见(2012年·广州)溃疡性结肠炎诊断部分解读[J].胃肠病学,2012,17(12):712-720.
[5] 李懿璇,李世荣,李俊霞,等.英夫利昔单抗一类克在激素抵抗及激素依赖溃疡性结肠炎治疗中的应用[J].世界华人消化杂志,2012,20(14):1987-1992.
[6] 米晓强,张雪梅,李爱华,等.英夫利西单抗联合硫唑嘌呤治疗对中重度溃疡性结肠炎患者血清白细胞介素-23及α1-抗胰蛋白酶水平影响[J].临床误诊误治,2016, 29(6):67-68.
[7] Lee SH,Kim MJ,Kim DW,et al. Amurensin G enhances the susceptibility to tumor necrosis factor-related apoptosis-inducing ligand-mediated cytotoxicity of cancer stem-like cells of HCT-15 cells [J]. Cancer Sci,2013,104(12):1632-1639.
[8] 郑紫丹,万晓强,刘梁英.溃疡性结肠炎患者血清IL-23和IL-17的水平变化及意义[J].细胞与分子免疫学杂志,2011,27(2):203-204.
[9] Ruffolo C,Scarpa M,Bassi N. Infliximab,azathioprine,or combination therapy for Crohn's disease [J]. N Engl J Med,2010,363(11):1086-1087.
[10] 刘嫦钦,邬瑞金,陈腾飞,等.微小核糖核酸-10a在炎症性肠病中的表达及其临床意义[J].中华消化杂志,2013, 33(5):321-325.
[11] Filho AG,Kinote A,Pereira D,J,et al. Infliximab prevents increased systolic blood pressure and upregulates the AKT/eNOS pathway in the aorta of spontaneously hypertensive rats [J]. Eur J Pharmacol,2013,700(1-3):201-209.
[12] 李荣富,高广周,孙涛,等.骨髓间充质干细胞在溃疡性结肠炎小鼠模型结肠的定位[J].国际消化病杂志,2016, 36(3):178-181.
[13] 邢娟,王力.美沙拉嗪联合培菲康治疗溃疡性结肠炎的疗效分析[J].中国现代医生,2015,53(24):31-33.
[14] 杨红,张慧敏,金梦,等.溃疡性结肠炎诊断与鉴别诊断要点解析[J].临床荟萃,2016,31(8):813-816.
[15] 李莉,曹江,刘玲,等.溃疡性结肠炎患者外周血IL-22及相关CD4+T细胞亚群的表达[J].中华微生物学和免疫学杂志,2012,32(4):323-325.
[16] Kornhluth A,Sachar DB,Practice Parameters Committee of the American College of Gastroenterology. Ulcerative colitis practice guidelines in adults:American College Of Gastroenterology,Practice Parameters Committee [J]. Am J Gxstroenterol,2010,105(3):501-523.
[17] 李勇,谢宜奎,丁红玲,等.美沙拉嗦与康复新液联合治疗溃疡性结肠炎的临床疗效及患者血清细胞因子的变化[J].山东医药,2012,52(25):55-56.
[18] 黄夺夏,陆翠钦,何张平,等.美沙拉嗦与康复新液联合治疗老年溃疡性结肠炎的疗效及对血清炎症细胞因子、凝血指标的影响[J].中国老年学杂志,2013,33(15):3769-3770.
[19] 郭晓鹤,张彩凤,夏水华,等.双歧杆菌四联活菌片联合芪倍合剂对溃疡性结肠炎患者T细胞亚群及Fas/Fast系统农达的调节[J].重庆医学,2014,43(14):1684-1686.
[20] 王坤,宣秀敏,王莲,等.溃疡性结肠炎人鼠外周血CD4+CD25+Treg的变化及相关性研究[J].安徽医科大学学报,2012,47(3):354-3511.
[21] 解春静,庄彦华,架雨笼.溃疡性结肠炎发病机制中免疫因素的研究进展[J].细胞与分子免疫学杂志,2013, 29(8):889-892.
[22] 傅水锦,张小牧,连人卫,等.肠炎清对溃疡性结肠炎模型人鼠中分泌型免疫球蛋自A和P选择素的影响[J].中国实验方剂学杂志,2014,20(3):148-152.
[23] 张劲松.柳氮磺吡啶灌肠联合双歧杆菌活菌制剂治疗溃疡性结肠炎的临床分析[J].中外医学研究,2015,13(35):60-61.
[24] Heuze ML,Vargas P,Chabaud M,et al. Migration of dendritic cells:physical principles,molecular mechanisms,and functional implications [J]. Immunol Rev,2013,256(1):240.
[25] El Assar M,Ruiz de Adana JC,Angulo J,et al. Preserved endothelial function in human obesity in the absence of insulin resistance [J]. J Transl Med,2013,11:263.
[26] Tam LS,Kitas GD,González-Gay MA. Can suppression of inflammation by anti-TNF prevent progression of subclinical atherosclerosis in inflammatory arthritis? [J]. Rheumatology(Oxlord),2014,53(6):1108-1119.
[27] Merad M,Sathe P,Helft J,et al. The dendritic cell lineage: ontogeny and function of dendritic cells and their subsets in the steady state and the inflamed setting [J]. Annu Rev Immunol,2013,31:563-604.