ω-3多不饱和脂肪酸辅助治疗溃疡性结肠炎的疗效及其机制研究

Effect and mechanism of Omega-3 polyunsaturated fatty acids in the treatment of ulcerative colitis

目的观察ω-3多不饱和脂肪酸(ω-3PUFAs)辅助治疗溃疡性结肠炎(UC)的临床疗效及对外周血Th17/Treg细胞平衡和细胞因子IL-10、IL-17水平的影响。方法采用前瞻性随机对照研究,选择2014年1月—2016年12月就诊于丽水市中心医院的UC患者共50例,采用随机数字表法分为2组。对照组25例,给予美沙拉嗪1 g口服,4次/d;观察组25例,在对照组基础上加用ω3-PUFAs 100 ml静滴,1次/d。其他非特异治疗措施2组相同,疗程均为1周。分别于治疗前后采用ELISA法检测血清IL-10、IL-17的表达水平,采用流式细胞仪检测外周血Treg细胞和Th17细胞的比例。比较2组患者治疗后的临床有效率,治疗前后血清IL-10、IL-17水平、外周血Treg细胞和Th17细胞比例的差异。结果观察组临床症状改善总有效率(88.0%)明显优于对照组总有效率(68.0%),差异有统计学意义(P<0.05)。与同组治疗前比较,2组患者外周血中Treg细胞比例、IL-10的水平均明显升高,而Th17细胞比例和IL-17的水平均明显下降,差异均有统计学意义(均P<0.05)。与对照组比较,观察组外周血中Treg细胞比例、IL-10水平的升高更显著,而Th17细胞比例和IL-17水平的下降更显著,差异有统计学意义(P<0.05)。结论ω-3PUFAs辅助治疗UC具有良好的临床疗效,其作用机制可能与调节Treg/Th17细胞的平衡而缓解UC的炎症反应有关。

Objective To observe the clinical efficacy of Omega-3 polyunsaturated fatty acids （omega-3PUFAs） in the treatment of ulcerative colitis （UC） and its influence on peripheral blood Th17/Treg cell balance and the levels of cyto- kines IL-10 and IL-17. Methods A prospective randomized controlled study was conducted. Fifty patients with UC were enrolled from Lishni Central Hospital in Zhejiang province from January, 2014 to December, 2016. The time and place of the study were added. The patients were divided into 2 groups by random number table. Twenty-five cases in Control group, mesalazine 1 g 4 times a day orally ; 25 cases in Observation group, mesalazine 1 g 4 times a day orally and ω3- PUFAs 100 ml 1 times a day intravenous drip. Other nonspeeific treatment measures were the same in the two groups, and the course of treatment was one weeks. The expressions of serum IL-10 and IL-17 were detected by ELISA, and the proportion of Treg cells and Th17 ceils in peripheral blood was detected by flow cytometry. The clinical effective rates of the two groups were compared. The levels of serum IL-10 and IL-17, the ratio of Treg cells and Th17 cells in peripheral blood before and after the treatment were compared. Results There was no significant difference between the two groups in age, sex, course of disease and severity of the disease （ P 〉 0.05 ）. The total effective rate of clinical symptom im- provement in the observation group （88%） was obviously better than that of the control group （68%）, the difference was statistically significant （P 〈 0.05）. Compared with the same group before treatment, the proportion of Treg cells and IL- 10 levels in peripheral blood of both groups increased significantly, while the proportion of Th17 cells and the level of IL- 17 were significantly decreased, the difference was statistically significant （P 〈 0.05 ）. Compared with Control group, the proportion of Treg cells and IL-10 levels in peripheral blood of the observation group increased more significantly, but the proportion of Th17 cells and the level of IL-17 decreased more significantly, the difference was statistically significant （ P 〈 0.05 ）. Conclusion ω-3 PUFAs has good clinical efficacy in the treatment of UC, and its mechanism may be re- lated to regulating the balance of Treg/Th17 and alleviating the inflammatory reaction of UC.