乌司他丁对溃疡性结肠炎患者血清炎症因子的影响

摘要

目的：观察乌司他丁对溃疡性结肠炎患者血清炎症因子的影响。方法：60例溃疡性结肠炎患者随机均分为观察组和试验组，同时选择20名健康志愿者作为健康对照组。试验组患者给予营养补充、维持水电解质平衡、5-氨基水杨酸等常规治疗；观察组患者在试验组治疗基础上加用乌司他丁20万U静脉注射，q12h。两组患者均以7 d为1个疗程，连续治疗2个疗程。观察两组患者治疗前后肿瘤坏死因子α（TNF-α）、白细胞介素1β（IL-1β）、IL-8、C反应蛋白（CRP）水平及结肠髓过氧化物酶（MPO）活性和病情活动指数（CAI）评分，并与健康对照组进行比较，同时记录不良反应发生情况。结果：两组患者治疗前后TNF-α、IL-1β、IL-8、CRP水平及MPO活性显著高于健康对照组，差异均有统计学意义（P＜0.05）。治疗后，两组患者TNF-α、IL-1β水平和MPO活性、CAI评分及观察组IL-8、CRP水平显著低于同组治疗前，且观察组TNF-α、IL-8、CRP水平显著低于试验组，差异均有统计学意义（P＜0.05）。两组患者均未见明显不良反应发生。结论：在常规治疗基础上加用乌司他丁可有效抑制溃疡性结肠炎患者多种血清炎症因子的表达，缓解结肠炎症反应与损伤，且安全性较好。%OBJECTIVE:To observe the effect of ulinastatin on the serum inflammatory cytokines of patients with ulcerative colitis. METHODS:Totally 60 patients with ulcerative colitis were randomly divided into observation group and test group,and an-other 20 healthy volunteers were selected as normal control group. Test group were received routine treatment,including nutrition support and maintaining water,electrolyte balance and 5-amino salicylic acid (5-ASA),etc. Patients in observation group were treated by ulinastatin 200 000 U by intravenous infusion based on the treatment of test group,q12h. 7 d were as a course for the pa-tients,and it lasted for 2 courses. The clinical data in healthy control group and other 2 groups was observed,including tumor ne-crosis factor-α(TNF-α),interleukin-1β(IL-1β),IL-8,C-reactive protein(CRP)levels,colon peroxidase activity(MPO),clinical activity index(CAI)scores and the incidence of adverse reactions before and after treatment. RESULTS:Before and after treatment, the TNF-α,IL-1β,IL-8,CRP and MPO in other 2 groups were significantly higher than health control group,with significant dif-ferences(P<0.05). After treatment,the TNF-α and IL-1β in 2 groups and the IL-8 and CRP levels in observation group were low than before,and the TNF-α,IL-8 and CRP levels in observation group were significantly lower than test group,with significant dif-ferences(P<0.05). There were no obvious adverse reactions during treatment. CONCLUSIONS:Based on the routine treatment, ulinastatin can effectively inhibit the expression of inflammatory cytokines of patients with ulcerative colitis,and relieve the inflam-mation and injury of colon,with good safety.