血清pANCA水平对柳氮磺胺吡啶治疗溃疡性结肠炎效果的影响

Effect of Serum pANCA Level on Sulfasalazine in Treatment of Ulcerative Colitis

目的探讨血清核周型抗中性粒细胞胞质抗体(p ANCA)对柳氮磺胺吡啶治疗溃疡性结肠炎效果的影响。方法选择2013年1月—2015年6月收治的溃疡性结肠炎患者74例,分为p ANCA阳性组与p ANCA阴性组,均采取柳氮磺胺吡啶治疗4周,比较两组患者临床疗效、不良反应、治疗前后临床症状积分及血清炎症指标。结果p ANCA阳性组总有效率显著高于p ANCA阴性组(P<0.05)。p ANCA阳性组治疗后腹痛、腹泻、黏液血便积分明显低于p ANCA阴性组(P<0.05)。两组治疗后白介素-6、C反应蛋白、降钙素原水平较入院时均明显下降,白介素-10水平明显上升(P<0.05),组间比较差异无统计学意义(P>0.05)。结论柳氮磺胺吡啶治疗血清p ANCA阳性溃疡性结肠炎疗效明确,能显著改善其临床症状,血清p ANCA可能对柳氮磺胺吡啶疗效有一定预测价值。

Objective To investigate the influence of serum anti- neutrophilic perinuclear antibody（ p ANCA）on the effect of Sulfasalazine in treatment of ulcerative colitis. Methods A total of 74 patients with ulcerative colitis admitted during January 2013 and June 2015 were divided into positive p ANCA group（ n = 40） and negative p ANCA group（ n = 34）. All the patients were treated with Sulfasalazine for 4 weeks. The curative effects,adverse reactions,clinical symptom scores before and after the treatment and serum inflammatory indexes were compared in the two groups. Results The total effective rate of positive p ANCA group was significantly higher than that of negative p ANCA group（ P〈0. 05）. The scores of abdominal pain,diarrhea and mucus bloody stool after treatment in positive p ANCA group were significantly lower than those in negative p ANCA group（ P〈0. 05）. After the treatment,the levels of serum interleukin-6（ IL-6）,C-reactive protein（ CRP） and procalcitonin（ PCT） were significantly decreased（ P〈0. 05）,while the interleukin-10（ IL-10） levels were significantly increased in the two group compared with those upon admission（ P〈0. 05）,but there were no significant differences between the two groups（ P〉0. 05）. Conclusion Sulfasalazine in treatment of serum p ANCA positive ulcerative colitis has good effect,and can significantly improve the clinical symptoms,and serum p ANCA may have some value in predicting the curative effect of Sulfasalazine.