摘要
目的：研究激素抵抗或者依赖的克罗恩病（erohn’s disease，CD）患者接受甲氨蝶呤治疗后的临床疗效及相关的炎症因子变化，从而探讨甲氨蝶呤治疗克罗恩病的可能机制。方法：分析我院2009年1月到2011年1月期间，27倒激素抵抗或者依赖的克罗恩病患者，接受MTX治疗，MTX20mg，肌肉注射，每周1次，疗程6个月。选取健康志愿者10例作为对照组，生理盐水2mL，肌肉注射，每周1次，疗程6月。采用克罗恩疾病活动指数积分（Crohn’s Disease Activity Index，CDAI）评价疗效，采用酶联免疫吸附双抗体夹心法（ELISA）检测健康对照纽以及CD患者MTX治疗前后血清中的IL-32，TNF-α、IL-2β、IL-6的浓度。结果：MTX治疗6月CDAI〈150（临床缓解）达到70．0％（14／20），ACDAI≥100（即治疗有效）达到15．0％（3／20）。CD患者血清中的相关细胞因子IL-32，TNF-α、IL-2β、IL-6等的水平均高于健康对照组，且差异具有统计学意义。MTX治疗后，血清中的细胞因子IL-32，TNF-α、IL-2β、IL-6均较治疗前明显降低，差异有统计学意义。结论：MTX能有效地缓解激素无效或者依赖CD患者的症状，其原因可能是通过下调TNF-α、IL-32、IL-2β、IL-6等相关因子的血清浓度发挥治疗作用。
Objective： To investigate the clinical benefit and impact on cytokine production by methotrexate（MTX） in Crohn＇ s disease （CD） ,furthormore to explore the qossible mechanism of methotrexate in CD. Methods ： 20 steroid - dependent or steroid - resistant patients treated in our hospital from Jan 2009 to Jan 2011 were treated with MTX 25mg/week intramuscularly as monotherapy for 6 months. Clinical outcome was measured with the Crohn＇ s Disease Activity Index（CDAI） at baseline and at the end of 1, 3 and 6 months. The cytokine IL -32, TNF - α,IL -2β,IL -6 were measured at baseline and at the end of 1, 3 and 6 months after the MTX treatment. Results： There was remarkable improvement in disease activity following the MTX treatment. At the end of 6 months, CDAI 〈 150 ,70.0% （14/20） and ACDAI≥ 100 15.0. 8% （3/20）. The levels of IL - 32,TNF - α,IL - 2β,IL - 6 were significantly higher than those of health control at the baseline, respectively. The levels of IL- 32, TNF- α,IL- 2β,IL- 6 were significantly decreased after treatment with methotrexate.
出处
《成都医学院学报》
CAS
2012年第03Z期12-14,共3页
Journal of Chengdu Medical College
