英夫利西单克隆抗体对活动期炎症性肠病患者外周血淋巴细胞亚群分布的影响  

Effects of infliximab on peripheral lymphocyte subsets of patients with active inflammatory bowel disease

作　　者：田雨[1] 李俊霞[1] 李懿璇[1] 王化虹[1] 刘新光[1] 

机构地区：[1]北京大学第一医院消化科,100034

出　　处：《中华消化杂志》2014年第1期41-44,共4页Chinese Journal of Digestion

摘　　要：目的研究英夫利西单克隆抗体（IFX）治疗前后IBD患者外周血淋巴细胞亚群分布的变化情况。方法收集2008年9月至2013年1月接受IFX治疗≥3次且按时随访的活动期IBD患者20例，其中UC患者11例，CD患者9例。以同时期20名健康体检者为健康对照组。IFX对UC和CD患者的疗效分别用治疗前后Mayo评分和简化CD活动指数评分进行评估。采集健康对照者的空腹静脉血，以及IBD患者在接受IFX治疗前1d和第3次IFX注射后24～72h内的空腹静脉血。采用荧光单克隆抗体标记和流式细胞术方法检测总T淋巴细胞、总B淋巴细胞、CD4＋T淋巴细胞、CD8＋。T淋巴细胞和NK细胞在淋巴细胞中所占的比例。两组间比较行独立样本t检验，3组间比较行方差分析。结果11例UC患者中3例临床缓解，3例临床好转，5例治疗无效。9例CD患者中1例临床缓解，6例临床好转，2例治疗无效。UC患者治疗前、后的总T淋巴细胞比例[分别为（84．2±8．1）％和（82．1±6．2）％]，以及治疗前的CD8＋T淋巴细胞比例[（40．0±13．2）％]均高于健康对照组[分别为（74．7±10．7）％和（30．5±11．9）％]，治疗前、后的NK细胞比例[（5．1±2．8）％和（7．8±4．3）％]均低于健康对照组[（13．7±7．8）％]，差异均有统计学意义（t=2．540、2．074、2．251、3．464、2．063，P均〈0．05）。UC患者治疗前、后的总B淋巴细胞和CD4＋T淋巴细胞比例，以及CD患者治疗前、后的总T淋巴细胞、总B淋巴细胞、CD4＋T淋巴细胞、CD8-T淋巴细胞和NK细胞比例与健康对照组比较差异均无统计学意义（P均〉O．05）。治疗前，治疗有效组、治疗无效组、健康对照组间总T淋巴细胞、CD8＋T淋巴细胞、NK细胞的比例差异均有统计学意义（F=4．095、4．571、7．432，P均〈0．05），其中治疗无效组[分别为（88．3±8．2）％、（44．4±11．5）％、（4．6±3．2）％]与健�Objective To investigate the change of the distribution of peripheral blood lymphocyte subsets, before and after treated by infliximab （IFX） in patients with inflammatory bowel disease （IBD）. Methods From September 2008 to January 2013, a total of 20 patients with IBD accepted more than three times of IFX treatment and on time follow-up were collected, 11 cases of ulcerative colitis （UC） and nine of Crohn＇s disease （CD）. At same time, 20 healthy individuals were enrolled as healthy control group. The efficacy of IFX on patients with UC or CD was evaluated according to Mayo score and simplified Crohn＇s disease active index （CDAI） before and after treatment. Fasting blood of healthy control group, one day before IFX treatment and in 24 to 72 hours after the third time of IFX injection of IBD patients was collected. The percentage of total T lymphocyte, total B lymphocyte, CD4＋ T lymphocyte, CD8＋ T lymphocyte and natural killer （NK） cell in lymphocyte was determined by fluorescent labeled monoclonal antibodies and flow cytometry. Independent sample t-test was performed for comparison between twogroups. Analysis of variance was for comparison among three groups. Results Three of 11 patients with UC achieved clinical remission, three cases were clinical improved and five cases were ineffectiveness. Among nine CD patients, one achieved clinical remission, six cases were clinical improved and two cases were ineffectiveness. Of UC patients, the percentage of total T lymphocyte before and after treatment （ （ 84.2 ± 8.1 ） % and （82.1 ±6.2） % ）, the percentage of CD8＋ T lymphocyte before treatment （ （ 40.0 ± 13.2）%） were all higher than that of healthy control group （（74.7±10. 7）% and （30. 5±11. 9）%）, while the percentage of NK cell before and after treatment （ （5.1 ±2.8） % and （7.8 ± 4.3） % ） were all lower than that of healthy control group （（13.7 ±7.8）%） and the differences were statistically significant （t=2.540, 2. 074, 2. 2

关 键 词：炎性肠疾病 淋巴细胞亚群 抗体 单克隆 药物疗法 

分 类 号：R574[医药卫生—消化系统]