营养支持联合IFX方案对重度溃疡性结肠炎患者炎性反应和Th细胞免疫应答的影响  

Effects of nutritional support combined with the infliximab regimen on inflammatory response and Th cellular immune response in patients with severe ulcerative colitis

作　　者：达鹏然 李罗红[1] 陈莎[1] 杨小莉[1] DA Pengran;LI Luohong;CHEN Sha(West China Hospital of Sichuan University,Sichuan,Chengdu 610041,China)

机构地区：[1]四川大学华西医院,成都市610041

出　　处：《河北医药》2023年第21期3272-3275,共4页Hebei Medical Journal

摘　　要：目的 探讨营养支持联合英夫利昔单抗(IFX)方案治疗重度溃疡性结肠炎患者炎性反应和Th细胞免疫应答的影响。方法 纳入2020年8月至2022年8月接受治疗的重度溃疡性结肠炎患者67例,临床治疗过程中转院、随访丢失后,最终入选试验的患者60例,按照单双号抽取随机分为2组,均采用常规对症治疗和常规护理,对照组(n=30)在常规治疗基础上采用英夫利昔单抗治疗,研究组(n=30)在常规治疗基础上同时给予营养支持治疗联合英夫利昔单抗治疗。对比2组患者的疗效、治疗前后肠道菌群数量和炎性因子水平。结果 研究组患者治疗总有效率为96.67%高于对照组的80.00%,差异有统计学意义(P<0.05)。研究组双歧杆菌、乳酸杆菌、消化球菌、真杆菌数量指标相比对照组均有大幅升高,肠球菌、肠杆菌、小梭菌数量指标均较低,差异均有统计学意义(P<0.05)。研究组治疗后的白介素-6(IL-6)、白介素-17(IL-17)、干扰素-γ(IFN-γ)前列腺素E2(PGE2)水平低于对照组,差异均有统计学意义(P<0.05)。结论 将营养支持联合英夫利昔单抗应用在重度溃疡性结肠炎患者中,可显著改善患者病情,维持肠道菌群平衡,调节炎性因子水平。Objective To explore the effect of nutritional support combined with infliximab(IFX)regimen on inflammatory response and Th cellular immune response in patients with severe ulcerative colitis.Methods Sixty-seven patients with severe ulcerative colitis who were treated in our hospital from August 2020 to August 2022 were included.After excluding transferred patients and those lost to follow-up,60 patients were finally recruited and divided into control group and study group according to odd and even numbers,with 30 patients per group.Patients in both groups were treated with routine symptomatic treatment and routine nursing.IFX and IFX combined with nutritional supplement therapy were applied to patients of control group and study group,respectively.The clinical efficacy,the abundances of gut microbiota and inflammatory factor levels before and after treatment were compared between the two groups.Results The total effective rate of treatment in the study group was significantly higher than that of control group(96.67%vs 80.00%,P<0.05).After treatment,the abundances of Bifidobacteria,Lactobacilli,Enterococci and Eubacteria in the study group were significantly higher than those of the control group,while those of Enterococcus,Enterobacter and Clostridium parvum were significantly lower(P<0.05).The interleukin-6(IL-6),interleukin-17(IL-17),interferonγ(IFN-γ)and prostaglandin E2(PGE2)levels after treatment were significantly lower in the study group than those of control group(P<0.05).Conclusion Nutritional supplement therapy combined with infliximab can significantly improve the condition,maintain the balance of gut microbiota and regulate inflammatory factor levels in patients with severe ulcerative colitis.

关 键 词：溃疡性结肠炎 营养支持治疗 英夫利昔单抗治疗 肠道菌群 炎性因子 

分 类 号：R574.62[医药卫生—消化系统]