Efficacy of vidlizumab in the adjuvant treatment of ulcerative colitis complicated with CMV infection and its effect on intestinal mucosal barrier function
Objective To study the efficacy of vidlizumab in the adjuvant treatment of ulcerative colitis complicated with cytomegalovirus(CMV)infection and its effect on intestinal mucosal barrier function Methods A total of 80 patients with ulcerative colitis complicated with CMV infection who received treatment in the Second People's Hospital of Nanyang City from January 2019 to December 2021 were selected for this study and divided into observation group(n=41)and control group(n=39)by random number table method.The control group was treated with mesalazine combined with ganciclovir,and the observation group was treated with verderizumab combined with ganciclovir.The clinical efficacy,intestinal mucosal function,intestinal microecology,changes in inflammatory factors[interleukin 8(IL-8),IL-23,tumour necrosis factor-α(TNF-α)]and the occurrence of adverse reactions were compared between the two groups.Results After treatment,the total effective rate was 90.24％in the observation group and 71.79％in the control group;the difference was statistically significant(x=4.466,P＜0.05).After treatment,the levels of D-lactic acid and lactulose/mannitol(L/M)in both the observation group and the control group were decreased,and the observation group(6.01±1.24)mg/L,(0.05±0.01)were lower than those in the control group(6.98±1.82)mg/L,(0.08±0.03),the differences were statistically significant(t=2.798,6.061;all P＜0.05).After treatment,the levels of lactobacillus and bifidobacterium increased in both the observation group and the control group,and the observation group(18.05±2.61)lgCFU/g,(16.85±1.75)lgCFU/g were higher than the control group(12.35±1.60)lgCFU/g,(13.08±1.28)lgCFU/g.The differences were statistically significant(t=1 1.704,10.951;all P＜0.05).The levels of enterococcus and Escherichia coli were decreased,and the level of the observation group(3.94± 0.21)lgCFU/g,(4.12±0.79)lgCFU/g was lower than that of the control group(6.54±0.38)lgCFU/g,(7.53±0.85)lgCFU/g.The differences were statistically significant(t=38.124,18.597;all P＜0.05).After treatment,the levels of inflammatory cytokines IL-8,IL-23,TNF-α decreased in both the observation group and the control group;the levels of the observation group(15.24±3.26)ng/L,(306.52±47.86)ng/L,(12.12±3.12)ng/L were lower than those of the control group(23.26± 4.19)ng/L,(512.26±63.54)ng/L,(16.02±5.16)ng/L.The differences were statistically significant(t=9.582,16.411,4.114;all P＜0.05).The main adverse reactions in the two groups were nausea,rash,fever and abnormal liver function,with the incidence rates of 4.88％and 7.69％,respectively,and there was no significant difference between the two groups(x2=0.270,P＞0.05).Conclusion During the treatment of ulcerative colitis complicated with CMV infection,vederizumab combined with ganciclovir had a significant effect,which could effectively improve the intestinal mucosal dysfunction,intestinal microecology and inflammation levels in patients.
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