摘要
目的探究双歧杆菌四联活菌联合英夫利西单抗(infliximab,IFX)治疗溃疡性结肠炎(ulcerative colitis,UC)的疗效。方法分析2022年1月至2024年1月在新疆军区总医院治疗的UC患者128例,采用抽签分组法分为IFX组(n=64,给予IFX方案治疗)和联合组(n=64,给予IFX联合双歧杆菌四联活菌治疗),比较两组患者临床疗效,比较两组患者T淋巴细胞亚群水平(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、炎症因子水平[肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)、白细胞介素6(IL-6)],比较两组实验室指标恢复时间、临床症状消失时间、不良反应总发生率。结果联合组临床总有效率89.07%(57/64)高于IFX组75.00%(48/64)(χ^(2)=4.293,P<0.05);治疗后,联合组患者CD3^(+)[(62.18±5.64)%vs(53.21±5.63)%]、CD4^(+)[(39.54±3.51)%vs(33.54±3.52)%]、CD4^(+)/CD8^(+)[(1.51±0.45)vs(1.16±0.45)]水平高于IFX组,CD8^(+)[(26.15±7.84)%vs(29.01±7.83)%]水平低于IFX组(t=9.005、9.656、4.400、2.065,P<0.05);治疗后,联合组患者TNF-α[(16.48±2.74)pg·mL^(-1) vs(20.45±2.78)pg·mL^(-1)]、IL-1β[(47.51±5.54)pg·mL^(-1) vs(56.54±5.53)pg·mL^(-1)]、IL-6[(70.42±6.51)pg·mL^(-1) vs(81.51±6.53)pg·mL^(-1)]水平低于IFX组(t=8.137、9.229、9.622,P<0.05);联合组患者便血消失时间[(11.53±2.14)d vs(14.54±2.18)d]、腹泻消失时间[(11.52±2.13)d vs(15.04±2.17)d]、C反应蛋白恢复正常时间[(8.15±1.04)d vs(11.17±2.31)d]、血沉恢复正常时间[(11.07±1.06)d vs(13.54±1.72)d]短于IFX组(t=7.883、9.239、9.537、9.780,P<0.05);两组不良反应总发生率差异无统计学意义(χ^(2)=0.699,P>0.05)。结论IFX联合双歧杆菌四联活菌治疗UC患者,能够提高临床疗效,提高患者免疫功能,降低炎症反应,缩短恢复时间,安全性高。
Objective To explore the efficacy of bifidobacterium quadruple viable bacteria combined with infliximab(IFX)in the treatment of ulcerative colitis(UC).Methods A total of 128 patients with UC who were treated in the Xinjiang Military Region General Hospital from January 2022 to January 2024,were divided into the IFX group(n=64,IFX regimen)and the combined group(n=64,IFX regimen combined with bifidobacterium quadruple viable bacteria)by drawing lots.The clinical efficacy,levels of T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),levels of inflammatory factors(tumor necrosis factorα(TNF-α),interleukin1β(IL-1β),interleukin-6(IL-6)),recovery duration of laboratory indexes,time of disappearance of clinical symptoms,and the total incidence rate of adverse reactions were compared between the two groups.Results The total clinical effective rate in the combined group was 89.07%(57/64),which was higher than that of the IFX group(75.00%(48/64))(χ^(2)=4.293,P<0.05).After treatment,the CD3^(+)level((62.18±5.64)%vs(53.21±5.63)%),CD4^(+)level((39.54±3.51)%vs(33.54±3.52)%)and CD4^(+)/CD8^(+)level((1.51±0.45)vs(1.16±0.45))in the combined group were higher than those in the IFX group while the CD8^(+)level((26.15±7.84)%vs(29.01±7.83)%)was lower compared to the IFX group(t=9.005,9.656,4.400,2.065,P<0.05).The TNF-α((16.48±2.74)pg·mL^(-1) vs(20.45±2.78)pg·mL^(-1)),IL-1β((47.51±5.54)pg·mL^(-1) vs(56.54±5.53)pg·mL^(-1))and IL-6((70.42±6.51)pg·mL^(-1) vs(81.51±6.53)pg·mL^(-1))in the combined group after treatment were lower than those in the IFX group(t=8.137,9.229,9.622,all P<0.05).In the combined group,the hematochezia disappearance time((11.53±2.14)d vs(14.54±2.18)d),diarrhea disappearance time((11.52±2.13)d vs(15.04±2.17)d),C-reactive protein normal recovery time((8.15±1.04)d vs(11.17±2.31)d),and normal recovery time of erythrocyte sedimentation rates((11.07±1.06)d vs(13.54±1.72)d)were shorter than those in the IFX group(t=7.883,9.239,9.537,9.780,P<0.05).No significant difference was exhibited in the total incidence rate of adverse reactions between the two groups(χ^(2)=0.699,P>0.05).Conclusion IFX regimen combined with bifidobacterium quadruple viable bacteria for patients with UC can improve the clinical efficacy and immune function,reduce the inflammatory response,and shorten the recovery time,with high safety.
作者
阿依古力·阿不力米提
赵金
靳迎春
刘荣喜
Ayguli Abramiti;Zhao Jin;Jin Yingchun;Liu Rongxi(Department of Gastroenterology,Xinjiang Military Region General Hospital of People’s Liberation Army,Urumqi 830001,China;Department of Gastroenterology,Xinjiang Uygur Autonomous Region People’s Hospital,Urumqi 830000,China)
出处
《中国药物应用与监测》
2025年第5期852-855,共4页
Chinese Journal of Drug Application and Monitoring
基金
新疆维吾尔自治区自然科学基金资助项目(2024DC79)。
关键词
英夫利西单抗
双歧杆菌四联活菌
溃疡性结肠炎
免疫功能
炎症反应
Infliximab
Bifidobacterium quadruple viable bacteria
Ulcerative colitis
Immune function
Inflammatory response
