英夫利西单抗联合硫唑嘌呤片对炎症性肠病患者T淋巴细胞的影响

摘要

Objective To observe the effect of infiiximab combined with azathioprine tablets on T lymphocytes in patients with inflammatory bowel disease (IBD).Methods Totally 98 patients with active IBD were divided into UC group (ulcerative colitis,n =50) and CD group (Krohn's disease,n =48),and patients with each kind of disease were divided into study group and control group.Control group received intravenous infusion of infliximab on the basis of routine treatment,and study group received oral azathioprine treatment on the basis of the treatment of control group.Twenty-five healthy persons were selected as control group.The clinical efficacy and the levels of T lymphocyte in peripheral blood were compared between study group and control group.Results After treatment,the total effective rate of study group was significantly higher than that of control group:UC group (96.00％ vs.72.00％),CD group (91.66％ vs.66.66％),the difference being statistically significant (P ＜0.05).After treatment,the levels of total T lymphocytes (CD3 +),CD4+ T lymphocytes and CD8 + T lymphocytes were increased (P ＜ 0.05),while the proportion of CD4+/CD8 + was decreased (P ＜ 0.05).Study group was significantly better than control group in the improvement of T lymphocyte (P ＜ 0.05).After UC treatment,the levels of CD3 +,CD4 +,CD8 + and CD4+/CD8 + recovered to the same level of healthy group.The levels of CD3 +,CD4 + and CD8 + in CD group recovered to the same level of healthy group after treatment.Conclusion Infliximab combined with azathioprine tablets can significantly improve IBD patients' T lymphocyte level,alleviate the abnormal distribution of lymphocytes,restore immune function,and improve the treatment efficiency.%目的 观察英夫利西单抗联合硫唑嘌呤片对炎症性肠病(Inflammatory bowel disease,IBD)患者外周血T淋巴细胞的影响.方法 将98例活动期IBD患者按照疾病种类分为UC组(溃疡性结肠炎,50例),CD组(克罗恩病,48例).每个疾病种类下设研究组和对照组,对照组在常规治疗基础上行静脉滴注英夫利西治疗,研究组在对照组基础上行口服硫唑嘌呤治疗.另将同期健康体检人员25例列为健康组作为参照.对比治疗后研究组和对照组临床疗效及外周血T淋巴细胞水平.结果 治疗后研究组总有效率均显著高于各自对照组:UC组(96.00％ vs.72.00％),CD组(91.66％ vs.66.66％),差异有统计学意义(P＜0.05);治疗后,两组外周血总T淋巴细胞(CD3+)及亚群CD4+T淋巴细胞、CD8+T淋巴细胞的比例水平均较治疗前显著升高,CD4+/CD8+比例较治疗前显著降低,差异有统计学意义(P＜0.05).研究组对T淋巴细胞水平改善情况显著优于各自对照组,差异有统计学意义(P＜0.05).UC组联合治疗后,CD3+、CD4+、CD8+、CD4+/CD8+水平恢复至同期健康组水平,CD组联合治疗后CD3+、CD4+、CD8+水平恢复至同期健康组水平.结论 英夫利西单抗联合硫唑嘌呤片能显著提高IBD患者T淋巴细胞水平,缓解患者淋巴细胞分布异常,恢复受损免疫功能,提高治疗有效率.