双歧杆菌三联活菌联合英夫利昔单抗治疗中重度溃疡性结肠炎的临床观察
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篇名: 双歧杆菌三联活菌联合英夫利昔单抗治疗中重度溃疡性结肠炎的临床观察
TITLE:
摘要: 目的:探讨双歧杆菌三联活菌联合英夫利昔单抗治疗中、重度溃疡性结肠炎(UC)的疗效及对患者免疫功能的影响。方法:选取2009年6月-2015年1月在重庆医科大学附属第一医院消化内科诊治的UC患者72例,依据治疗方案的不同分为单药组和联合组,各36例。单药组患者分别于第0、2、6、8周给予英夫利昔单抗5 mg/kg治疗1次,ivgtt;联合组患者在对照组基础上加用双歧杆菌三联活菌420 mg,tid;两组患者均连续治疗2个月。比较两组患者的临床疗效及治疗前后体液免疫和T细胞水平,并观察两组患者不良反应发生情况。结果:联合组患者临床有效率为86.11%,显著高于单药组的52.78%,差异有统计学意义(P<0.05)。治疗前,两组患者体液免疫功能和T细胞水平比较,差异无统计学意义(P>0.05);治疗后,两组患者CD4+和CD4+/CD8+的水平明显增高,CD8+、Th1和Th2水平显著下降,且联合组显著优于对照组,差异均有统计学意义(P<0.05);两组患者治疗前后CD3+比较,差异无统计学意义(P>0.05);治疗后,两组患者免疫球蛋白(Ig)A和IgG水平显著升高,补体C3水平显著降低,且联合组显著优于对照组,差异均有统计学意义(P<0.05);两组患者治疗前后IgM含量和补体C4水平比较,差异无统计学意义(P>0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:双歧杆菌三联活菌联合英夫利昔单抗治疗中、重度UC疗效显著,能够明显改善患者的体液免疫功能,促进T细胞水平的恢复,且安全性较好。
ABSTRACT: OBJECTIVE: To investigate therapeutic efficacy of bifidobacteria triple viable bacteria combined with infliximab in the treatment of moderate and severe ulcerative colitis (UC), and its effects on immune function. METHODS: Seventy-two UC patients were selected from gastroenterology department of the First Affiliated Hospital of Chongqing Medical University during Jun. 2009 to Jan. 2015. They was divided into single group and combination group according to therapy plan, with 36 cases in each group. Single group was given infliximab 5 mg/kg, ivgtt, on 0, 2nd, 6th, 8th week. Combination group was additionally given bifidobacteria triple viable bacteria 420 mg, tid. Both groups were treated for consercutive 2 months. Clinical efficacies were compared between 2 groups as well as the levels of humoral immunity and T cell function. The occurrence of ADR was observed in 2 groups. RESULTS: Clinical response rate of combination group was 86.11%, which was significantly higher than 52.78% of single group, with statistical significance (P<0.05). Before treatment, there was no statistical significance in humoral immunity and T cell function between 2 groups (P>0.05). After treatment, the levels of CD4+ and CD4+/CD8+ were significantly increased in both 2 groups, while the levels of CD8+, Th1 and Th2 were significantly decreased; the combination group was significantly better than the control group, with statistical significance (P<0.05); there was no statistical significance in CD3+ between 2 groups before and after treatment (P>0.05). After treatment, the levels of IgA and IgG were increased significantly in 2 groups, and the level of C3 was decreased significantly; the combination group was significantly better than the control group, with statistical significance (P<0.05); there was no statistical significance in IgM content and C4 level between 2 groups before and after treatment (P>0.05). There was no statistical significance in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS: Bifidobacteria triple viable bacteria combined with infliximab shows significant therapeutic efficacy in the treatment of moderate and severe UC, and can significantly improve humoral immunity function and the recovery of T cell level, with good safety.
期刊: 2017年第28卷第5期
作者: 张玲,李昌平,姜政,张秉强,罗玲
AUTHORS: ZHANG Ling,LI Changping,JIANG Zheng,ZHANG Bingqiang,LUO Ling
关键字: 双歧杆菌三联活菌;英夫利昔单抗;溃疡性结肠炎;体液免液;T细胞功能
KEYWORDS: Bifidobacteria triple viable bacteria; Infliximab; Ulcerative colitis; Humoral immunity; T cell function
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