美沙拉嗪对溃疡性结肠炎患者血清TNF-α、IL-6、IL-17表达及肠道屏障功能的影响

摘要

Objective To investigate the effect of mesalazine on the expression of TNF-α, IL-6, IL-17 and intestinal barrier function in patients with ulcerative colitis. Methods 76 patients with UC from January 2015 to April 2016 in The Fifth Central Hospital of Tianjin were collected and randomly divided into control group and observation group with 38 cases in each group. After admission were given maintenance of water and electrolyte, basic acid-base balance and nutritional support treatment, and the control group were treated with conventional drug sulfasalazine (SASP) treatment, two tablets each time, four times once day, four weeks for each course, the observation group was treated with mesalazine, four tablets each time, three times once day, four weeks each course of treatment. The levels of TNF-α, IL-6, IL-17, L/M and Baron endoscopic scores in the two groups were observed after two courses of treatment. The efficacy and side effects of the two groups were compared. Results No dropout or dropout cases in this study, two groups after the treatment of TNF-α, IL-6, IL-17, L/M, Baron scores were significantly decreased (P<0.05), but the observation group after treatment the above indexes were all significantly lower than the control group (P<0.05), the total effective rate of the observation group was 89.47%(34/38) higher than that of the control group 71.05%(21/38), the adverse reaction rate of 13.16% (5/38) was lower than that in the control group 34.21% (13/38), the differences were statistically significant(P<0.05). Conclusion Compared with conventional drug SASP, the effect of on the expression of TNF-α, IL-6 and IL-17 in serum of patients with UC and the improvement of intestinal barrier function can be effectively suppressed, which has the advantages of clinical efficacy and low adverse reaction rate.%目的 探讨美沙拉嗪(5-ASA)对溃疡性结肠炎(ulcerative colitis,UC)患者血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-6(interleukin-6,IL-6)、白细胞介素-17(interleukin-17,IL-17)表达及肠道屏障功能的影响.方法 收集天津市第五中心医院于2015年1月~2016年4月期间肛肠科确诊收治的76例UC患者为研究对象,采用随机平行对照法将其分为对照组和观察组各38例.入院后均给予维持水电解质、酸碱平衡及营养支持等基础治疗,对照组口服常规药物柳氮磺吡啶(SASP)治疗,2片/次,4次/天,4周1疗程;观察组口服美沙拉嗪治疗,4片/次,3次/天,4周1疗程.均持续治疗2个疗程后观察2组血清炎症因子TNF-α、IL-6、IL-17,尿乳果糖/甘露醇比值(L/M)和Baron内镜评分的变化,比较2组疗效及不良反应发生情况.结果 本研究无中途退出或脱落病例,2组治疗后TNF-α、IL-6、IL-17、L/M值、Baron评分分别较治疗前均有显著下降(P<0.05),但观察组治疗后上述指标较对照组均显著较低(P<0.05);观察组治疗总有效率89.47%(34/38)较对照组71.05%(21/38)高,不良反应率13.16%(5/38)较对照组低34.21%(13/38),差异均具有统计学意义(P<0.05).结论 和常规药物SASP相比,美沙拉嗪能有效抑制UC患者血清TNF-α、IL-6、IL-17表达和改善肠道屏障功能,具有临床疗效肯定、不良反应率低的优点.