摘要
目的本文研究英夫利昔单抗联合不同免疫抑制剂治疗溃疡性结肠炎的疗效。方法选取我院2011年12月至2014年12月结肠炎患者120例,随机分为A、B、C、D四组,每组30例,A组给予英夫利昔单抗联合糖皮质激素,B组给予英夫利昔单抗联合硫唑嘌呤,C组给予英夫利昔单抗联合环磷酰胺,D组(对照组)患者单纯给予英夫利昔。比较四组患者临床疗效、复发率、肿瘤坏死因子(TNF-α)、血清中炎性因子[白介素-6(IL-6)、白介素-8(IL-8)、纤维蛋白原(Fib)、血小板体积(MPV)变化水平及不良反应发生率。结果 D组(对照组)患者的治疗总有效率为53.33%较A组(70.00%)、B组(93.33%)和C组(80.00%)低(P<0.05),联合用药各组血清中TNF-α、IL-6、IL-8、Fib水平均低于对照组(P<0.05),联合用药各组MPV水平均高于对照组(P<0.05)。对照组不良反应高于联合用药各组(P<0.05),联合用药各组中B组不良反应发生率6.67%较A组(26.67%)、C组(13.33%)低,差异有统计学意义(P<0.05)。结论硫唑嘌呤、环磷酰胺联合英夫利昔单抗治疗结肠炎效果均优于单一用药,硫唑嘌呤联合英夫利昔单抗可有效维持治疗效果,显著降低复发率,效果较优。
Objective Toinvestigatethe effects of infliximab combined with different immunosuppressantsin ulcerative colitis. Methods 120patients with ulcerative colitis were recruited from our hospital from December 2011 to December 2014. Patientswererandomized in- to fourgroups,with 30 casesin each group. Group A receivedinfliximab combined with glucocorticoids, group Binfliximab combined with azathioprine, group Cinfliximab combined withcyclophosphamide, and groupDwithinfliximab alone as the control group. The effective- ness rate, recurrence rate, changes serum levels of inflammatory factors,including Tumor Necrosis Factor-a（TNF-a）, Interleukin-6 （IL-6）, Interleukin-8 （IL-8）,coagulation indices, including fibrinogen （Fib） and mean platelet volume （MPV）,and the incidence rate of adverse reactions were comparedamonggroups. Results The overall effectiveness rate in group D （53.33%） was significantly lower than that in group A （70.00%）, group B （93.33%） and group C （80.00%）（P〈0.05）. The levels ofserumTNF-a, IL-6, IL-8 and Fib were significantly lower and MPV level significantly higher in the combination treatmentgroupsthan those inthe control group （all P〈 0.05 ）.Incidence of adverse events was higher in the control group than in the combination groups. Incidence of adverse events was 6.67% in group B, which was significantly lower than group A （26.67%） and group C （13.33%） （all P〈0.05）. Conclusion Infliximab combined with azathioprineor cyclophosphamide had higher effectiveness ratethan monotherapy in the treatment of ulcerative colitis. In- fliximab combined with azathioprine had the highest effectiveness rate and lowest risk of adverse events.
出处
《结直肠肛门外科》
2016年第5期506-509,共4页
Journal of Colorectal & Anal Surgery
