凝血酶灌肠治疗溃疡性结肠炎的疗效

Effect of thrombin in enema on treating ulcerative colitis

目的 :观察凝血酶灌肠治疗溃疡性结肠炎 ( UC)的疗效。方法 :将 4 0例活动期 U C患者随机分为 2组 ,各组又分轻、中、重度。轻度予以氢化可的松 10 0 mg/ d、柳氮碘吡啶 2 g/ d保留灌肠 ,中、重度分别加用甲泼尼龙 4 0 mg/ d或 4 0～ 80 mg/ d,iv;治疗组 18例患者在灌肠液中加凝血酶 4 0 0 U ,疗程 2 wk。结果 :治疗组与对照组的轻度患者血便持续日分别为 ( 6.4 2±1.3 8)和 ( 8.63± 2 .12 ) d;中度患者为 ( 9.2 0± 2 .0 8)和 ( 12 .4 7± 3 .2 3 ) d,平均每日大便次数则分别为 ( 1.67± 0 .64)和 ( 2 .61±0 .92 )次 ;重度患者血红蛋白下降分别为 ( 2 7.5 2± 6.87) g/ L和 ( 3 5 .83± 5 .72 ) g/ L ,均有统计学差异 ( P<0 .0 5 )。治疗 2 wk后明显缓解的 10例治疗组 UC患者作治疗前后 SIL - 2 R比较 ,轻度患者无变化 ,中度患者则有显著性下降 ( P<0 .0 5 ) ,分别为( 74 .0 7± 7.4 6) pmol/ L和 ( 5 5 .3 2± 15 .3 8) pmol/ L。结论 :加用凝血酶灌肠对各种严重程度的

AIM: To observe the effect of thrombin on treating ulcerative colitis (UC). METHODS: Fourty (40) cases of UC patients in active term were divided into 2 groups randomly,and each group was further divided into mild, moderate and severe types.Patients with mild UC received retention enema with hydrocortisone 100 mg/d, Salazosulfadimidine 2 g/d, respectively; besides, methylprednisolone 40 and 40 80 mg iv, qd was added to the retention enemas of moderate and severe patients respectively,while thrombin 400 U in enema was given to 18 patients in treatment group.The study lasted for 2 wk. RESULTS: The data of treatment group were compared with the control group as follows: in mild type patients,persistent days of blood feces were (6 42±1 38) and (8 63±2 12) respectively; in moderate type patients,they were (9 20±2 08) and (12 47±3 23), and average bowel movements per day were (1 67±0 64) and (2 61±0 92) respectively; in severe type patients, the hemoglobin decreased was (27 52±6 87) and (35 83±5 72) g/L respectively; there were significant differences in these data ( P <0 05). SIL 2R in 10 cases of UC patients in treatment group who remitted obviously showed significant differences in moderate cases 2 wk after treatment (74 07±7 46) pmol/L as compared with before treatmennt (55 32±15 38) pmol/L, but not in mild ones. CONCLUSION: Adding thrombin to enema solution is effective in treating patients with mild,moderate and severe UC.