英夫利昔单抗联合硫唑嘌呤对克罗恩病患者免疫功能和细胞因子的影响

目的 探讨英夫利昔单抗(IFX)联合硫唑嘌呤(AZA)对克罗恩病(Crohn's disease,CD)患者免疫功能和细胞因子的影响。 方法 以随机数字法将170例克罗恩病患者随机分为2组,每组85例。对照组给予硫唑嘌呤,观察组在对照组的基础上加用英夫利昔单抗。比较2组生物学指标白细胞计数(WBC)、血沉(ESR)、C-反应蛋白(CRP)和血清总蛋白(STP)]、免疫功能指标T淋巴细胞亚群(CD4、CD4/CD8和CD8)、免疫球蛋白(IgA、IgG、IgM)]、炎性细胞因子肿瘤坏死因子-α(TNF-α)、白介素-10(IL-10)、白介素-12(IL-12)、转化生长因子β(TGF-β)]、临床疗效和不良反应发生率。 结果 治疗后,2组WBC、ESR、CRP、STP、CD4、CD4/CD8、CD8、IgA、IgG、IgM、TNF-α、IL-12、TGF-β、IL-10水平均较前明显改善(P<0.05),且观察组WBC、ESR、CRP、STP、CD4、CD4/CD8、CD8、IgA、IgG、IgM、TNF-α、IL-12、TGF-β、IL-10水平显著优于对照组(P<0.05)。观察组治疗总有效率为92.9%,显著高于对照组的80.0%(P<0.05)。2组患者不良反应率比较差异无统计学意义(P>0.05)。 结论 英夫利昔单抗联合硫唑嘌呤可有效改善克罗恩病患者的免疫功能和炎性细胞因子,治疗效果满意。 

Influence of infliximab combined with azathioprine on immune function and cytokines in Crohn's disease

Objective To evaluate the clinical efficacy of infliximab combined with azathioprine in treatment of Crohn's disease and its effect on immune function and cytokines level. Methods One hundred and seventy patients with Crohn's disease were randomly divided into 2 groups with 85 cases in each group.The patients in the control group were given azathioprine,while the patients in the observation group were given additional infliximab based on the treatment in the control group.The biological indicators countingwhite blood cell (WBC),erythrocyte sedimentation rate (ESR),C-reactive protein (CRP) and serum total protein (STP)],immune function indexesperipheral blood T lymphocyte subsets (CD4 percentage,CD4/CD8 and CD8 percentage),and immunoglobulin (IgA,IgG,IgM)],inflammatory cytokinestumor necrosis factor alpha (TNF-α) and interleukin-10(IL-10),interleukin-12(IL-12),transforming growth factor beta (TGF-β)],clinical effect and adverse reactions of the two groups were compared. Results After the treatment,WBC,ESR,CRP,STP,CD4,CD4/CD8,CD8,IgA,IgG,IgM,TNF-α,IL-12,TGF-β and IL-10 levels of the two groups were significantly improved when compared with those before the treatment (P<0.05),and those indicators levels of the observation group were significantly better than those of the control group (P<0.05).The total effective rate in the observation group was 92.9%,which was significantly higher than 80.0% in the control group,P<0.05.There was no significant difference in the adverse reactions between the two groups (P>0.05). Conclusion Infliximab combined with azathioprine can effectively improve the immune function and inflammatory cytokines of patients with Crohn's disease,the curative effect is satisfactory.