2021 年第 12 期 第 16 卷

维多珠单抗联合美沙拉嗪治疗溃疡性结肠炎患者的效果及对肠黏膜屏障功能和免疫功能的影响

Effect of vedolizumab combined with mesalazine on patients with ulcerative colitis and its impact on intestinal mucosal barrier function and immune function

作者：潘春生王维王科菊

英文作者：Pan Chunsheng Wang Wei Wang Keju

单位：三二〇一医院消化内科，陕西省汉中市723000

英文单位：Department of Gastroenterology 3201 Hospital Shaanxi Province Hanzhong 723000 China

关键词：溃疡性结肠炎；维多珠单抗；美沙拉嗪；肠黏膜屏障功能

英文关键词：Ulcerativecolitis;Vedolizumab;Mesalazine;Intestinalmucosalbarrierfunction

• 摘要：

• 目的 探讨维多珠单抗联合美沙拉嗪治疗溃疡性结肠炎患者的效果及对肠黏膜屏障功能和免疫功能的影响。方法 选取2020年3月至2021年3月三二〇一医院消化内科收治的90例溃疡性结肠炎患者，利用随机数字表法分为观察组和对照组，各45例。对照组在基础治疗基础上接受美沙拉嗪治疗，观察组在基础治疗基础上接受维多珠单抗联合美沙拉嗪治疗，均治疗8周。比较2组临床疗效、治疗前后血清肠黏膜屏障功能指标（D-乳酸、二胺氧化酶、内毒素）、免疫功能指标（CD+3、 CD+4、CD+8）、氧化应激指标［超氧化物歧化酶（SOD）、丙二醛、过氧化脂质（LPO）］及不良反应发生情况。结果  观察组治疗后总有效率明显高于对照组［88.9%（40/45）比71.1%（32/45）］（P＜0.001）。治疗后观察组血清D-乳酸、二胺氧化酶、内毒素水平均低于对照组，CD+3、CD+4水平均高于对照组，CD+8水平低于对照组，血清SOD水平高于对照组，血清丙二醛、LPO水平低于对照组（均P＜0.05）。2组治疗期间不良反应发生率比较差异无统计学意义（P=0.365）。结论  维多珠单抗联合美沙拉嗪治疗溃疡性结肠炎具有良好的疗效，可有效改善肠黏膜屏障功能和免疫功能，减轻氧化应激反应，且安全性较好。

• Objective To investigate the effect of vedolizumab combined with mesalazine on patients with ulcerative colitis and its impact on intestinal mucosal barrier function and immune function. Methods From March 2020 to March 2021, 90 patients with ulcerative colitis admitted in Department of Gastroenterology, 3201 Hospital were enrolled . They were randomly divided into observation group and control group, with 45 cases in each group. The control group was treated with mesalazine on the basis of conventional treatment, and the observation group was treated with vedolizumab combined with mesalazine on the basis of conventional treatment, both groups were treated for 8 weeks. The clinical efficacy, serum intestinal mucosal barrier function indexes (D-lactic acid, diamine oxidase, endotoxin), immune function indexes (CD+3, CD+4, CD+8), oxidative stress indexes ［superoxide dismutase (SOD), malondialdehyde (MDA), lipid peroxide (LPO)］ before and after treatment, and adverse reactions were compared between the two groups. Results The total effective rate in the observation group was significantly higher than that in the control group［88.9%（40/45） vs 71.1%（32/45）］(P＜0.001). After treatment, the serum levels of D-lactic acid, diamine oxidase and endotoxin in the observation group were significantly lower than those in the control group, the levels of CD+3, CD+4 in the observation group were higher than those in the control group, the level of CD+8 in the observation group was lower than those in the control group, the level of serum SOD in the observation group was higher than those in the control group, and the levels of serum MDA and LPO in the observation group were lower than those in the control group (all P＜0.05). There was no significant difference in the incidence of adverse reactions between the two groups during treatment（P=0.365）. Conclusions   Vedolizumab combined with mesalazine has good curative efficacy on ulcerative colitis. It can effectively improve intestinal mucosal barrier function and immune function and reduce oxidative stress response with good safety.