英夫利西单抗对溃疡性结肠炎患者外周血淋巴细胞亚群的影响

目的观察英夫利西单抗（IFX）对溃疡性结肠炎（UC）患者外周血淋巴细胞亚群分布的影响。方法将医院收治并接受IFX治疗的23例溃疡性结肠炎患者作为观察组,以同时期23名健康体检者作为对照组。观察组患者于入组第0,2,6周分别接受IFX静脉滴注治疗,剂量为5 mg/kg,第14周维持治疗1次。治疗前后采用Mayo评分、简化CD活动指数（CDAI）评分及内镜下CD严重度指数（CDEIS）评分对观察组治疗疗效进行评估。采集观察组治疗前1 d、治疗14周后及对照组患者空腹静脉血样本,检测总T淋巴细胞、总B淋巴细胞、CD4＋T淋巴细胞、CD8＋T淋巴细胞及NK细胞的比例。结果观察组治疗后Mayo评分、CDAI评分及CDEIS评分均较治疗前显著改善（P〈0.05）;IFX治疗前,观察组中16例临床治疗有效患者外周血总T淋巴细胞、CD8＋T淋巴细胞及NK细胞比例明显高于其余7例治疗无效组患者（P〈0.05）;观察组治疗后总T淋巴细胞、CD4＋T淋巴细胞、CD8＋T淋巴细胞及NK细胞比例均明显增高（P〈0.05）,总B淋巴细胞比例未见明显改变（P〉0.05）。治疗后观察组总T淋巴细胞、总B淋巴细胞、CD4＋T淋巴细胞及CD8＋T淋巴细胞与对照组相比均未见明显差异（P〉0.05）,NK细胞比例显著低于对照组（P〈0.05）。结论外周血淋巴细胞亚群的改变与UC的发病明显相关,IFX治疗UC具有良好的临床疗效。

Effects of Infliximab on Peripheral Lymphocyte Subsets in Patients with Ulcerative Colitis

Objective To observe the effect of infliximab（ IFX） on the distribution of peripheral lymphocyte subsets in the patients with ulcerative colitis（ UC）. Methods 23 patients with UC in our hospital were selected as the observation group. At same time,23 healthy individuals of the physical examination were enrolled as the control group. The observation group received the intravenous drip of IFX5 mg / kg in 0, 2, 6 weeks and once maintenance treatment in 14 weeks. The Mayo scores, simplified Crohn＇s disease activity index（ CDAI） and CDEIS score before and after treatment were adopted to evaluate the effects of IFX. Fasting venous blood samples in the observation group were collected for detecting total T lymphocytes, total B lymphocytes, CD4＋T lymphocytes, CD8＋T lymphocytes and the proportion of NK cells. Results The Mayo scores,CDAI scores and CDEIS scores after treatment in the observation group were significantly improved compared with before treatment（ P〈0. 05）; the peripheral blood total T lymphocytes, CD8＋T lymphocytes and proportion of NK cells before IFX treatment in 16 effective cases in the observation group were significantly higher than those in the 7ineffective cases（ P〈0. 05）; the total T lymphocytes,CD4＋T lymphocytes,CD8＋T lymphocytes and proportion of NK cells in the observation group were significantly improved after treatment（ P〈0. 05）, while the total B lymphocytes had no obvious change（ P〉0. 05）.There were no statistically significantly differences in the total T lymphocytes,total B lymphocytes,CD4^＋T lymphocytes and CD8^＋T lymphocytes after treatment between the observation group and the control group（ P〉0. 05）,but the proportion of NK cells in the observation group was significantly lower than that in the control group（ P〈0. 05）. Conclusion The changes of peripheral blood lymphocyte subsets is significantly associated with the UC pathogenesis. IFX has good effects in the treatment of UC.