维得利珠单抗联合美沙拉嗪治疗活动期溃疡性结肠炎疗效观察  

The Efficacy of Vedolizumab Versus Mesalazine in Active Ulcerative Colitis

作　　者：林笑晗 贲腾 LIN Xiaohan;BEN Teng(Department of Gastroenterology,Haian People's Hospital,Haian,Jiangsu 226600,China;Department of Imaging,Haian People's Hospital,Haian,Jiangsu 226600,China)

机构地区：[1]江苏省海安市人民医院消化内科,江苏海安226600 [2]江苏省海安市人民医院影像科,江苏海安226600

出　　处：《转化医学杂志》2024年第9期1474-1478,共5页Translational Medicine Journal

摘　　要：目的 探讨维得利珠单抗与美沙拉嗪治疗活动期溃疡性结肠炎(UC)的临床疗效及安全性。方法 选择2019年1月至2023年12月海安市人民医院活动期UC患者105例为研究对象,随机分为维得利珠单抗组(n=53)和美沙拉嗪组(n=52)。2组患者均给予常规治疗,在此基础上维得利珠单抗组予维得利珠单抗治疗,美沙拉嗪组给予美沙拉嗪治疗。观察并对比2组患者临床疗效,治疗前后肠黏膜屏障功能相关指标、炎症因子水平及肠道菌群含量,并记录不良反应发生率。结果 维得利珠单抗组总有效率为94.34%,高于美沙拉嗪组的80.77%(χ^(2)=4.456,P <0.05)。治疗后,维得利珠单抗组D-乳酸、内毒素水平及炎症因子白细胞介素17(IL-17)、IL-23水平[分别为(4.98±1.23)μg/L、(2.26±0.92) U/mL、(206.74±15.34) pg/L、(252.93±19.43) pg/L]均低于美沙拉嗪组[分别为(6.25±1.87)μg/L、(3.41±1.13) U/mL、(224.89±16.56) pg/L、(280.32±20.89) pg/L](t=4.119、5.724、5.828、6.958,均P <0.05),乳酸杆菌、双歧杆菌含量[分别为(19.65±2.34) lg CFU/g、(17.34±1.98) lg CFU/g]高于美沙拉嗪组[分别为(14.89±1.76) lg CFU/g、(14.01±1.45) lg CFU/g],大肠杆菌、肠球菌含量[分别为(3.92±0.78) lg CFU/g、(3.71±0.56) lg CFU/g]低于美沙拉嗪组[分别为(6.25±1.23) lg CFU/g、(6.05±0.89) lg CFU/g](t=11.763、9.817、11.615、16.157,均P <0.05)。治疗期间,2组患者的不良反应发生率差异无统计学意义(P> 0.05)。结论 维得利珠单抗治疗活动期UC较美沙拉嗪能更有效地缓解临床症状,改善肠道黏膜屏障功能及菌群水平,降低炎症因子水平,且不良反应发生率低。Objective To explore the clinical efficacy and safety of vedolizumab and mesalazine in the treatment of active ulcerative colitis(UC).Methods A total of 105 patients with active UC who received targeted treatment in our hospital from January 2019 to December 2023 were selected as the subjects of this experiment and randomly divided into the vedolizumab group(53 cases)and the mesalazine group(52 cases).Patients in both groups were given conventional treatment.On this basis,the vedolizumab group was treated with vedolizumab,and the mesalazine group was treated with mesalazine.The clinical efficacy,the indicators related to intestinal mucosal barrier function,the specific concentration levels of inflammatory factors and the intestinal flora before and after treatment were observed and compared between the two groups,and the specific occurrence probability of adverse reactions was recorded.Results The total effective rate of treatment in the vedolizumab group was 94.34%,which was higher than that in the mesalazine group(80.77%)(χ^(2)=4.456,P<0.05).After treatment,the levels of D-lactic acid,endotoxin and inflammatory factors IL-17 and IL-23 in the vedolizumab group[(4.98±1.23)μg/L,(2.26±0.92)U/mL,(206.74±15.34)pg/L,(252.93±19.43)pg/L,respectively]were lower than those in the mesalazine group[(6.25±1.87)μg/L,(3.41±1.13)U/mL,(224.89±16.56)pg/L,(280.32±20.89)pg/L,respectively](t=4.119,5.724,5.828,6.958,all P<0.05),the levels of Lactobacillus and Bifidobacterium[(19.65±2.34)lg CFU/g,(17.34±1.98)lg CFU/g]were higher than those in the mesalazine group[(14.89±1.76)lg CFU·g^(-1),(14.01±1.45)lg CFU/g],and the levels of Escherichia coli and Enterococcus[(3.92±0.78)lg CFU/g,(3.71±0.56)lg CFU/g]were lower than those in the mesalazine group[(6.25±1.23)lg CFU/g,(6.05±0.89)lg CFU/g](t=11.763,9.817,11.615,16.157,all P<0.05).During the treatment period,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Vedolizumab is more effective than mesalazine in

关 键 词：维得利珠单抗 美沙拉嗪 结肠炎 溃疡性 疗效比较研究 肠黏膜屏障功能 炎症因子 

分 类 号：R574.621[医药卫生—消化系统]