英夫利西单抗联合IPAA治疗溃疡性结肠炎临床观察  

Clinical Observation of Infliximab Combined with IPAA in the Treatment of Ulcerative Colitis

作　　者：李圣强 刘春 康英杰 LI Shengqiang;LIU Chun;KANG Yingjie(Hebei Yiling Hospital,Shijiazhuang,Hebei,China 050091;Baoding Jingxiu District Hospital,Baoding,Hebei,China 071051)

机构地区：[1]河北以岭医院,河北石家庄050091 [2]河北省保定市竞秀区医院,河北保定071051

出　　处：《中国药业》2022年第18期91-93,共3页China Pharmaceuticals

基　　金：河北省医学科学研究重点课题[20211324]。

摘　　要：目的探讨英夫利西单抗联合回肠贮袋肛管吻合术(IPAA)治疗溃疡性结肠炎的临床疗效。方法选取河北以岭医院2019年1月至2021年10月收治的溃疡性结肠炎患者126例,按随机抽签法分为观察组和对照组,各63例。两组患者均予对症治疗及IPAA治疗,观察组患者术后加用注射用英夫利西单抗5 mg/kg缓慢(≥2 h)静脉滴注。结果观察组总有效率为92.06%,显著高于对照组的77.78%(P<0.05)。与对照组比较,观察组患者治疗后的腹泻、腹痛、便血消退时间及住院时间均显著缩短;细胞间黏附分子-1(ICAM-1)、单核细胞趋化蛋白-1(MCP-1)、血管细胞黏附分子-1(VCAM-1)的表达水平均显著降低;T淋巴细胞亚群CD_(3)^(+)、CD_(4)^(+)水平及CD_(4)^(+)/CD_(8)^(+)均显著升高,CD_(8)^(+)水平显著降低(P<0.05)。观察组与对照组不良反应发生率相当(12.70%比7.94%,P>0.05)。结论英夫利西单抗联合IPAA治疗溃疡性结肠炎,可缩短腹泻、腹痛、便血症状消退时间,降低ICAM-1,MCP-1,VCAM-1的表达水平,改善T淋巴细胞亚群水平。Objective To investigate the clinical efficacy of infliximab combined with ileal pouch-anal anastomosis(IPAA)in the treatment of ulcerative colitis.Methods A total of 126 patients with ulcerative colitis admitted to the Hebei Yiling Hospital from January 2019 to October 2021 were selected and divided into the observation group and the control group by the random lottery method,with 63 cases in each group.The patients in the two groups were given symptomatic treatment and IPAA treatment,on this basis,the patients in the observation group were slowly(≥2 h)given 5 mg/kg of infliximab intravenously after the operation.Results The total effective rate in the observation group was 92.06%,which was significantly higher than 77.78% in the control group(P<0.05).Compared with those in the control group,the regression time of diarrhea,abdominal pain,hematochezia and the length of hospital stay in the observation group were significantly shorter,the expression levels of intercellular adhesion molecule-1(ICAM-1),monocyte chemoattractant protein-1(MCP-1)and vascular cell adhesion molecule-1(VCAM-1)in the observation group were significantly lower,the levels of T lymphocyte subsets including CD_(3)^(+),CD_(4)^(+)and CD_(4)^(+)/CD_(8)^(+)in the observation group were significantly higher,while the level of CD_(8)^(+)in the observation group was significantly lower(P<0.05).The incidence of adverse drug reactions in the observation group was similar to that in the control group(12.70%vs.7.94%,P>0.05).Conclusion Infliximab combined with IPAA in the treatment of ulcerative colitis can shorten the regression time of diarrhea,abdominal pain and hematochezia,reduce the expression levels of ICAM-1,MCP-1 and VCAM-1,and improve the levels of T lymphocyte subsets.

关 键 词：英夫利西单抗 回肠贮袋肛管吻合术 溃疡性结肠炎 抗炎作用 临床疗效 

分 类 号：R969.4[医药卫生—药理学] R975[医药卫生—药学]