活动期炎症性肠病患者英夫利西单抗治疗前后的外周血淋巴细胞亚群状况研究

Peripheral blood lymphocyte subsets of patients with inflammatory bowel disease before and after drug treatment activities

目的探讨英夫利西单抗对活动期炎症性肠病患者外周血淋巴细胞亚群的影响。方法以2010年6月—2014年5月该院收治的活动期炎症性肠病患者23例为研究对象,根据疾病种类分为溃疡性结肠炎组(UC组)和克罗恩病组(CD组),选取同期23例正常者作为健康组,观察药物疗效及治疗前后患者的外周血淋巴细胞亚群变化、炎性反应,对比治疗有效组与无效组的淋巴细胞亚群水平。结果 UC组15例,临床缓解5例(33.33%),好转3例(20.00%),无效7例(46.67%),总有效率为53.33%;CD组8例,临床缓解1例(12.50%),好转5例(62.50%),无效2例(25.00%),总有效率为75.00%。治疗前后UC组的CD3+、CD4+、CD4+/CD8+、NK均低于健康组,治疗后上述指标有所升高,且CD3+、CD4+与健康组的组间差异不具有统计学意义(P>0.05)。治疗前,CD组患者的CD3+、CD4+、CD8+、CD4+/CD8+、NK与健康组的组间差异均具有统计学意义(P<0.05),治疗后,患者CD3+、CD4+、CD4+/CD8+、NK明显升高,且CD3+、CD4+、CD8+、NK与健康组的组间差异不具有统计学意义(P>0.05)。治疗有效组与无效组患者的CD4+无明显差异,治疗有效组患者的CD3+、CD4+/CD8+、NK较无效组更高,CD8+明显较低,差异具有统计学意义(P<0.05)。结论英夫利西单抗治疗后炎症性肠病患者的CD8+水平降低,CD3+、CD4+、CD4+/CD8+、NK均有所升高,接近正常水平。

Objective To explore the peripheral blood lymphocyte subsets of patients with inflammatory bowel disease before and after drug treatment activities with infliximab.Methods Twenty -three patients with active inflammatory bowel disease,who were treated in Jingyang Hospital of Maternal and Chinld Healthcare from June 2010 to May 2014,were selected and assigned into ulcer colitis group （UC）and Crohn＇s disease group （CD group）,and another 23 healthy persons were selected during the same period as healthy group. We pbserved the drug efficacy before and after treatment,and the changes of peripheral blood lymphocyte subsets in patients,inflamma-tory reaction,and compared the lymphocytes subsets level between the effective treatment group and the ineffective treatment group.Re-sults Of 15 cases in UC group,5 cases（33.33%）clinically remitted,3 cases（20.00%）improved,7 cases （46.67%）invalid.The total effective rate was 53.33%.Of 8 cases in group CD,1 case（12.50%）clinically remitted,5 cases （62.50%）improved,2 cases （25%）invalid.The total effective rate was 75%.Before and after treatment CD3^ ＋,CD4 ^＋,CD4 ^＋/CD8 ^＋,NK in UC group were lower than those in the healthy group.The above -mentioned indexes increased after treatment,and there were no statistical differences in CD3 ^＋,CD4 ^＋ between UC group and the healthy group （P 〉0.05）.Before treatment,there were significant differences in CD3^ ＋, CD4^ ＋,CD8^ ＋,CD4 ^＋/CD8 ^＋ and NK between CD group and the healthy group （P 〈0.05）.After treatment CD3 ^＋,CD4 ^＋,CD4 ^＋/CD8^ ＋ and NK increased significantly,and there were no significant differences between CD group and the healthy group （P 〉0.05）. There was no significant difference in CD4^ ＋ between the effective treatment group and the ineffective treatment group,while CD3^ ＋, CD4^ ＋/CD8^ ＋,NK were higher and CD8 ^＋ was significantly lower in effective treatment group with significant differences （P 〈0.05）. Conclusions After the treatment with infliximab,the level of CD8 ^＋ in patients was decreased,while the levels of CD3 ^＋,CD4 ^＋, CD4^ ＋/CD8^ ＋ and NK were increased,close to the normal level.