摘要
[目的]探讨沙利度胺联合强的松治疗溃疡性结肠炎(UC)的临床疗效及对患者肠屏障功能、炎症指标的影响.[方法]回顾性分析2021年4月至2023年3月本院收治的92例UC患者的临床资料,根据治疗方案不同将其分为对照组(在常规治疗的基础上给予强的松治疗)和观察组(在对照组的基础上给予沙利度胺治疗),每组46例.治疗8周后,比较两组疗效、病情相关评分[梅奥内镜(Mayo)评分、UC内镜严重程度指数(UCEIS)评分]、肠屏障功能相关指标[二胺氧化酶(DAO)、血乳酸(LAC)、细菌脂多糖(LPS)、D乳酸(D-LA)]、炎症相关指标[Toll样受体4(TLR-4)、核因子κB(NF-κB)、可溶性晚期糖化终末产物受体(sRAGE)]及不良反应发生率.[结果]观察组总有效率高于对照组,差异有统计学意义(P＜0.05).治疗后,两组Mayo评分、UCEIS评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P＜0.05);两组血清DAO、LAC、LPS、D-LA水平低于治疗前,且观察组低于对照组,差异有统计学意义(P＜0.05);两组NF-κB、TLR-4、sRAGE低于治疗前,且观察组低于对照组,差异有统计学意义(P＜0.05).两组不良反应发生率比较,差异无统计学意义(P＞0.05).[结论]沙利度胺联合强的松治疗UC效果较好,可减轻肠黏膜炎症,改善肠屏障功能,且安全性较高.
Abstract
[Objective]To investigate the clinical efficacy of thalidomide combined with prednisone in the treatment of ulcerative colitis(UC)and its effects on intestinal barrier function and inflammatory indicators in patients.[Methods]A ret-rospective analysis was conducted on the clinical data of 92 UC patients admitted to our hospital 1 from April 2021 to March 2023.According to the treatment plan,they were divided into the control group(treated with prednisone in addition to con-ventional treatment)and the observation group(treated with thalidomide in addition to the control group),with 46 patients in each group.After 8 weeks of treatment,the efficacy,disease-related scores(Mayo endoscopic score,UC endoscopic se-verity index(UCEIS)score),intestinal barrier function related indicators[diamine oxidase(DAO),blood lactate(LAC),bacterial lipopolysaccharide(LPS),D-lactate(D-LA)],inflammation related indicators[Toll like receptor 4(TLR-4),nuclear factor kappa B(NF-κB),soluble late glycation end product receptor(sRAGE)],and adverse reactions were com-pared between the two groups.[Results]The total effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P＜0.05).After treatment,the Mayo score and UCEIS score of both groups were lower than before treatment,and the observation group was lower than the control group,with statistical significance(P＜0.05);The levels of serum DAO,LAC,LPS,and D-LA in both groups were lower than before treat-ment,and the observation group was lower than the control group,with statistical significance(P＜0.05);The levels of NF-κB,TLR-4,and sRAGE in both groups were lower than before treatment,and the observation group was lower than the control group,with statistically significant differences(P＜0.05).There was no statistically significant difference in the total effective rate of adverse reactions between the two groups(P＞0.05).[Conclusion]The combination of thalido-mide and prednisone has a good therapeutic effect on UC,which can reduce intestinal mucosal inflammation,improve intes-tinal barrier function,and is relatively safe.
维普
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