美沙拉秦联合更昔洛韦治疗巨细胞病毒感染相关性溃疡性结肠炎的临床研究

Clinical Study of Mesalazine Combined with Ganciclovir in Treatment of Ulcerative Colitis Associated with Cytomegalovirus Infection

目的:探讨美沙拉秦联合更昔洛韦治疗巨细胞病毒(CMV)感染相关性溃疡性结肠炎(UC)的效果。方法:选取2019年1月至2022年12月我院诊治的86例CMV感染相关性UC患者,随机分为对照组和研究组,各43例,对照组予美沙拉秦肠溶片治疗,研究组予美沙拉秦肠溶片+更昔洛韦治疗,2组均治疗1个月。比较2组CMV转阴率、临床治疗总体疗效、临床症状消退时间,以及治疗前后的炎症指标、凝血指标。结果:研究组CMV转阴率(90.70%)高于对照组(72.09%),临床治疗总有效率(93.02%)高于对照组(65.12%),P<0.05。研究组脓血便、腹痛、腹泻症状消退时间均明显短于对照组,P<0.05。治疗后,2组炎症指标肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、白细胞介素-6(IL-6)及凝血指标纤维蛋白原(Fib)较治疗前均降低(P<0.05),炎症指标白细胞介素-10(IL-10)及凝血指标血小板体积(MPV)较治疗前均升高(P<0.05);治疗后组间比较,研究组TNF-α、CRP、IL-6、Fib明显低于对照组(P<0.05),IL-10、MPV高于对照组(P<0.05)。结论:美沙拉秦联合更昔洛韦治疗CMV感染相关性UC可有效提高CMV转阴率和临床疗效,促进症状消退,减轻炎症反应,改善凝血功能。

Objective To investigate the effect of Mesalazine combined with Ganciclovir in the treatment of ulcerative colitis(UC)associated with cytomegalovirus(CMV)infection.Methods A total of 86 pa-tients with UC associated with CMV infection diagnosed and treated in our hospital from January 2019 to December 2022 were randomly divided into the control group and the study group,43 cases in each group.The control group was treated with Mesalazine enteric-coated tablets,and the study group was treated with Mesalazine enteric-coated tablets+Ganciclovir,and both groups were treated for 1 month.The CMV nega-tive conversion rate,the overall clinical therapeutic effect,the clinical symptom regression time,and the in-flammatory and coagulatory indicators before and after treatment were compared between the two groups.Results The CMV negative conversion rate of the study group(90.70%)was higher than that of the control group(72.09%),and the total effective rate of clinical treatment in the study group(93.02%)was higher than that of the control group(65.12%)(P<0.05).The symptom regression time of pus and blood stool,abdominal pain and diarrhea in the study group was significantly shorter than that in the con-trol group(P<0.05).After treatment,the levels of tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),interleukin-6(IL-6)and coagulatory index fibrinogen(Fib)in both groups were decreased com-pared with those before treatment(P<0.05),and the levels of inflammatory index interleukin-10(IL-10)and coagulatory index platelet volume(MPV)were higher than those before treatment(P<0.05).After treatment,the levels of TNF-α,CRP,IL-6 and Fib in the study group were significantly lower than those in the control group(P<0.05),while the levels of IL-10 and MPV were higher than those of the control group(P<o.05).Conclusion Mesalazine combined with Ganciclovir in the treatment of UC associated with CMV infection can effectively improve the negative conversion rate of CMV and clinical ef-ficacy,promote the regression of symptoms,reduce inflammation and improve coagulation function.