溃疡性结肠炎患者外周血及结肠黏膜TNF-a、IL-6和IL-2变化的临床意义

发布时间：2018-05-31 11:27

本文选题：溃疡性结肠炎 + TNF-a　；参考：《中国现代医学杂志》2016年14期

【摘要】：目的考察溃疡性结肠炎(UC)患者外周血及结肠黏膜肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)和白细胞介素2(IL-2)变化并探讨其意义。方法收集2008年1月-2013年1月贵阳市第二人民医院门诊及住院的活动期UC患者85例。根据病情严重程度将患者分为3组:轻度31例、中度25例和重度29例,选肠镜检查正常的健康体检者25例为对照组。检测所有受试者,UC患者治疗前后外周血和结肠黏膜TNF-α、IL-6和IL-2水平,并进行比较。结果治疗前,各个UC组外周血和结肠黏膜TNF-α和IL-6水平明显高于对照组(P0.05),IL-2明显低于对照组(P0.05),随着严重程度增加,TNF-α和IL-6增高,IL-2降低,治疗后,UC组外周血和结肠黏膜TNF-α、IL-6及IL-2水平和对照组差异无统计学意义(P0.05),外周血TNF-α分别与IL-6和IL-2呈正相关(r=0.733,P=0.009)和负相关(r=-0.674,P=0.017),IL-6和IL-2呈负相关(r=-0.615,P=0.032),结肠黏膜的TNF-α分别与IL-6和IL-2呈正相关(r=0.755,P=0.005)和负相关(r=-0.584,P=0.042),IL-6和IL-2呈负相关(r=-0.533,P=0.049),外周血TNF-α和IL-6分别与Geboes呈正相关(r=0.684,P=0.012;r=0.722,P=0.0011),IL-2与Geboes呈负相关(r=-0.631,P=0.021)。所有患者随访3、6、12和24个月,UC复发者分别为1、3、3和4例,合计11例,失访者分别为1、2、1和2例,复发率分别为1.19%(1/84)、3.66%(3/82)、3.70%(3/81)和5.06%(4/79),合计复发率为13.90%。结论 UC患者外周血及结肠黏膜TNF-a、IL-6和IL-2与UC严重程度相关,评估TNF-α、IL-6和IL-2有助于判断UC治疗的"黏膜愈合",对预后有较准确的指导价值。
[Abstract]:Objective to investigate the changes of tumor necrosis factor- 伪 (TNF- 伪), interleukin-6 (IL-6) and interleukin-2 (IL-2) in peripheral blood and colon mucosa of patients with ulcerative colitis (UC). Methods from January 2008 to January 2013, 85 patients with active UC in the outpatient and inpatient department of the second people's Hospital of Guiyang City were collected. According to the severity of the disease, the patients were divided into three groups: mild 31 cases, moderate 25 cases and severe 29 cases. The levels of TNF- 伪 IL-6 and IL-2 in peripheral blood and colonic mucosa of all patients with UC before and after treatment were measured and compared. Results before treatment, the levels of TNF- 伪 and IL-6 in peripheral blood and colonic mucosa in all UC groups were significantly higher than those in control group (P 0.05) and IL-2 was significantly lower than that in control group (P 0.05). With the increase of severity, TNF- 伪 and IL-6 increased and IL-2 decreased. After treatment, the levels of TNF- 伪 IL-6 and IL-2 in peripheral blood and colonic mucosa in UC group were not significantly different from those in control group (P 0.05). The levels of TNF- 伪 in peripheral blood were positively correlated with IL-6 and IL-2, respectively. There was a negative correlation between TNF- 伪 and IL-6 and IL-2 (P 0.009) and negative correlation between TNF- 伪 and IL-6 and IL-2 in colonic mucosa. Positive correlation was found between TNF- 伪 and Geboes (0.755P0. 005) and negative correlation between IL-6 and IL-2. TNF- 伪 and IL-6 in peripheral blood were positively correlated with Geboes, respectively. There was a negative correlation between IL-2 and Geboes. All the patients were followed up for 12 and 24 months with UC recurrence in 3 cases and 3 cases respectively. The total number of cases was 11, and that of the missing patients was 1 1 / 2 and 2, respectively. The recurrence rate was 1. 19 / 84 / 3. 66 / 32 / 3. 70 / 83) and 5. 06% / 47 / 79, respectively. The total recurrence rate was 13. 90%. Conclusion IL-6 and IL-2 in peripheral blood and colonic mucosa are related to the severity of UC. The evaluation of TNF- 伪 IL-6 and IL-2 is helpful to judge the "mucosal healing" of UC, and has a more accurate guiding value for prognosis.
【作者单位】：贵州省贵阳市第二人民医院消化内科;
【基金】：贵阳市科技计划项目(No:20141001)
【分类号】：R574.62

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