摘要
目的研究不同剂量环孢素A对溃疡性结肠炎激素增敏机制。方法选择本院2010年7月至2014年7月住院治疗的129例溃疡性结肠炎患者,随机分为A、B、C三组,每组43例,三组均给予常规激素治疗,A在激素基础上给予环孢素A 2 mg/(kg·d)、B组在激素基础上给予环孢素A 4 mg/(kg·d)口服,C组不增加环孢素A。治疗2月后比较三组临床疗效,随访1年观察转换治疗率,比较三组治疗前后白介素-6(IL-6)、白介素-8(IL-8)及肿瘤坏死因子α(TNF-α)水平,并观察用药期间不良反应发生率。结果 A、B组疗效比较差异无统计学意义(P>0.05),两组临床疗效均优于C组(P<0.05),三组复发率比较差异无统计学意义(P>0.05);A、B两组转换治疗率及手术率比较差异无统计学意义(P>0.05),A、B两组1年转换治疗率显著低于C组(P<0.05),三组1年后手术率比较差异无统计学意义(P<0.05);治疗前三组各炎性指标比较差异无统计学意义(P>0.05),治疗后IL-6、IL-8及TNF-α较治疗前均显著降低(P<0.05),A、B组治疗后比较差异无统计学意义(P>0.05),均显著低于C组(P<0.05);A、B、C三组不良反应发生率比较差异无统计学意义(P>0.05)。结论在使用激素基础上加用环孢素A治疗溃疡性结肠炎可提高单纯激素的抗炎效果,有利于增强疗效,且不会增加不良反应发生率,低剂量环孢素A可发挥与高剂量基本相当的增效作用,具有较高的临床价值。
Objective To study the sensitization mechanism of different doses of cyclosporine A in the treatment of ulcerative colitis.Methods 129 patients ulcerative colitis in our hospital were randomized into A,B and C groups,with 43 cases in each group. All groups were given conventional hormone therapy. In addition,group A and group B were treated with oral administration of 2 mg/（kg·d）and 4 mg/（kg·d）of cyclosporine A,respectively. After 2 months of treatment,the clinical efficacy was compared. All groups were followed up for 1 year to observe the rate of switching therapy. The levels of interleukin-6（IL-6）,interleukin-8（IL-8）and tumor necrosis factor alpha（TNF-α）were compared between groups,and the incidence of adverse reactions during medication was recorded.Results There was no significant difference inclinical efficacy between group A and group B（P〉0. 05）,but the clinical efficacy of these two groups was better than that of group C（P〈0. 05）. There was no significant difference in the recurrence rate amongthe three groups（P〉0. 05）. 1 year conversion treatment ratein group A and B was significantly lower than that in group C（P〈0. 05）.The operation rate amongthe three groups was not statistically significant（P〈0. 05）. There was no significant difference in the inflammatory indexes between groups before treatment（P〉0. 05）. After treatment,levels of IL-6,IL-8 and TNF-α were significantly lower than those before treatment（P〈0. 05）and the levels showed no significant difference between group A and group B（P〉0. 05）,but the levels in these two groups were significantly lower than those in group C（P〈0. 05）. There was no significant difference in the incidence of adverse reactions among the three groups（P〉0. 05）.Conclusion Hormone combined with cyclosporine A can improve the anti-inflammatory effect of hormone alone,and itenhances the curative effect. Low-dose cyclosporine A can play similarsynergism role as high-dose,without increasing the inc
作者
韦明勇
彭薛
石小琼
张姗
谢汶甫
熊鹰
吴军
Wei Mingyong Peng Xue Shi Xiaoqiong Zhang Shan Xie Wenpu Xiong Ying Wu Jun.(Department of Internal Medicine, Sichuan A- cademic City Hospital, Mianyang, Sichuan, 621900, China)
出处
《结直肠肛门外科》
2017年第3期352-355,共4页
Journal of Colorectal & Anal Surgery
关键词
环孢素A
溃疡性结肠炎
糖皮质激素
增敏
Cyclosporin A
ulcerative colitis
glucocorticoid
sensitization
