抗TNF-α制剂对克罗恩病合并肛瘘患者术后血清炎性细胞因子水平及其病情远期复发率的影响

Effect of anti-TNF-preparation on serum inflammatory cytokine level and long-term recurrence rate of patients with Crohn’s disease complicated with anal fistula after operation

目的:探讨为接受手术的克罗恩病合并肛瘘患者使用抗肿瘤坏死因子α(TNF-α)制剂进行治疗对其血清炎性细胞因子水平、病情远期复发率的影响。方法:选取2018年2月至2019年2月期间红河州第一人民医院收治的58例克罗恩病合并肛瘘患者作为研究对象。将这些患者平均分为试验组和对照组。两组患者入院后,均对其进行单行挂线引流术。手术后,用抗TNF-α制剂对试验组患者进行治疗。然后比较两组患者病情的远期复发率、瘘管愈合的平均时间、肛周克罗恩病活动指数(PDAI)的评分、克罗恩病活动指数(CDAI)的评分、白介素-4(IL-4)/干扰素-γ(IFN-γ)值、转化生长因子-β(TGF-β)/白介素-17(IL-17)值。结果:手术后,试验组患者病情的远期复发率、PDAI的评分、CDAI的评分均低于对照组患者,P<0.05;其瘘管愈合的平均时间短于对照组患者,P<0.05;其IL-4/IFN-γ值、TGF-β/IL-17值均小于对照组患者,P<0.05。结论:用抗TNF-α制剂对进行手术后的克罗恩病合并肛瘘患者进行治疗,可降低其血清炎性细胞因子的水平及病情的远期复发率。

Objective:To investigate the effects of TNF-preparation on serum inflammatory cytokines and long-term recurrence in patients with crohn’s disease complicated with anal fistula after surgery.Methods:Fifty-eight patients with crohn’s disease complicated with anal fistula admitted to The First People’s Hospital of Honghe Prefecture from February 2018 to February 2019 were selected as study subjects.The patients were evenly divided into a test group and a control group.After admission,the two groups of patients were treated with single wire hanging drainage.After surgery,patients in the experimental group were treated with an anti-TNF-agent.The long-term recurrence rate,mean time to fistula healing,perianal Crohn’s disease activity index(PDAI)score,Crohn’s disease activity index(CDAI)score,interleukin-4(IL-4)/interferon-(IFN-)value,and transformed growth factor-(TGF-)/interleukin-17(IL-17)value were then compared between the two groups.Results:After operation,the long-term recurrence rate,PDAI score and CDAI score in the experimental group were all lower than those in the control group(P<0.05).The mean time of fistula healing was shorter than that of the control group(P<0.05).The il-4/IFN-and TGF-/IL-17 values were all lower than those in the control group(P<0.05).Conclusion:Anti-TNF-therapy can reduce the serum inf lammatory cytokine level and the long-term recurrence rate in p atients with crohn’s disease complicated with anal fistula after operation.