丹参多酚酸盐对溃疡性结肠炎的疗效

Therapeutic effect of salvianolate against ulcerative colitis

目的:探讨溃疡性结肠炎(ulcerative colitis,UC)患者血小板改变情况,并观察丹参多酚酸盐对UC的治疗作用及对患者血小板计数(platelet count,PLT),血小板平均体积(mean platelet volume,MPV),及血沉(erythrocyte sedimentation rate,ESR),血清C反应蛋白(C-reactive protein,CRP)的影响.方法:检测110例UC患者及84例健康者PLT、MPV、ESR、CRP,并将80例UC患者随机分为对照组(常规治疗32例)和治疗组(常规治疗加丹参多酚酸盐50mg静脉滴注48例),比较两组治疗前后病情改善情况.结果:UC患者PLT较健康对照者升高(292.0±104.8vs217.2±45.6,P<0.05),而MPV较对照组降低(9.1±0.8vs10.5±1.1,P<0.05).重度组UC患者较轻度组UC患者PLT升高(292.0±104.8vs244.2±74.8,P<0.05),轻、中度组(244.2±74.8vs255.0±52.3,P>0.05)及中、重度组(255.0±52.3vs292.0±104.8,P>0.05)UC患者PLT无明显差异;轻、中、重度组间MPV(9.5±0.6vs9.2±0.6vs8.5±1.0),ESR(6.1±4.5vs17.1±9.0vs30.0±19.7),CRP(9.3±4.3vs14.7±9.8vs31.2±21.0)差异均有统计学意义(P<0.05).治疗组的总有效率及完全缓解率均优于对照组(93.8%vs75.0%,P<0.05).两组治疗后治疗组PLT(218.0±34.8vs245.0±45.3),ESR(7.3±5.1vs14.7±4.7),CRP(8.3±3.7vs11.6±6.4)低于对照组,MPV高于对照组(10.1±1.0vs9.7±0.8,P<0.05).结论:PLT、MPV可作为UC病情的评估指标,丹参多酚酸盐通过降低PLT,活化程度及活血化瘀而改进UC的治疗效果,有必要对丹参多酚在UC治疗中的作用作进一步研究.

AIM： To investigate the correlation between changes in platelets and coagulation and disease severity in patients with ulcerative colitis （UC） and to investigate the therapeutic effect of salvianolate against UC. METHODS： One hundred and ten patients with UC and 84 healthy controls were included in the study. Platelet count （PLT）, mean platelet volume （MPV）, erythrocyte sedimentation rate （ESR）, and C-reactive protein （CRP） were compared between UC patients and healthy controls. UC patients were randomly divided into a control group and a treatment group. The control group received only routine treatment, while the treatment group received both salvianolate and routine treatment. PLT, MPV, ESR, and CRP were compared between the two groups. Stool characters and colonoscopy performance were also observed to evaluate the treatment effect.RESULTS： PLT in UC patients was superior to that in normal controls （292.0 ± 104.8 vs 217.2 ± 45.6）, while MPV in UC patients was inferior to that in normal controls （9.1 ± 0.8 vs 10.5 ± 1.1, P 0.05）. PLT was higher in patients with severe disease than in those with mild disease （292.0 ± 104.8 vs 244.2 ± 74.8, P 0.05）. There was no significant difference in PLT between patients with mild and those with moderate disease （244.2 ± 74.8 vs 255.0 ± 52.3, P 0.05）, or between those with moderate and severe disease （255.0 ± 52.3 vs 292.0 ± 104.8, P 0.05）. There were significant differences in MPV （9.5 ± 0.6 vs 9.2 ± 0.6 vs 8.5 ± 1.0）, ESR （6.1 ± 4.5 vs 17.1 ± 9.0 vs 30.0 ± 19.7）, CRP （9.3 ± 4.3 vs 14.7 ± 9.8 vs 31.2 ± 21.0） between patients with mild, moderate and severe disease （all P 0.05）. PLT （218.0 ± 34.8 vs 245.0 ± 45.3）, ESR （7.3 ± 5.1 vs 14.7 ± 4.7） and CRP （8.3 ± 3.7 vs 11.6 ± 6.4） were lower, but the effective rate （93.8% vs 75.0%） and MPV（10.1 ±1.0 vs 9.7±0.8） were higher in the treatment group than in the control group after therapy （all P 0.05）. CONCLUSION： PLT and MPV can be used as markers for assessing the severity of UC. Treatment with salvianolate can improve the treatment effect of UC by reducing PLT number and activation and activating blood circulation.