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      标题:甘草酸制剂强力宁联合曲安奈德对溃疡性结肠炎患者外周血高迁移率族蛋白B1及Toll样受体与肝功能的影响
      作者:韩振中,王军,张红波    (西安市北方医院消化内分泌内科,陕西 西安 710043)
      卷次: 2018年29卷1期
      【摘要】 目的 探讨甘草酸制剂强力宁联合曲安奈德对溃疡性结肠炎(UC)患者血高迁移率族蛋白 B1(HMGB1)、Toll样受体(TLR)及肝功能的影响。方法 选择2011年3月至2015年2月西安市北方医院消化内分泌内科收治的64例溃疡性结肠炎患者,按随机数字表法分为对照组与观察组各32例。对照组单用曲安奈德治疗,观察组在此基础上加用甘草酸制剂强力宁治疗,疗程均为4周,分别于治疗前后采集患者外周血,测定HMGB1及白介素-6 (IL-6)、白介素-10 (IL-10)的水平,并取结肠组织标本,测定TLR-2、TLR-4阳性率,治疗期间均监测肝功能,观察患者症状及体征的改善情况,记录临床治疗效果。结果 ①观察组患者的治疗总有效率为87.50%,略高于对照组的71.88%,但差异无统计学意义(P>0.05);②治疗前两组患者的血HMGB1、IL-6、IL-10水平比较差异均无统计学意义(P>0.05),治疗后,两组患者的HMGB1、IL-6水平均降低,IL-10上升,与治疗前比较差异均有统计学意义(P<0.05),且观察组患者的HMGB1、IL-6水平降低幅度高于对照组[(2.15±0.21) μg/L、(190.22±20.12) pg/mL vs(3.37±0.42) μg/L、(206.11±15.36) pg/mL ],IL-10上升幅度高于对照组[(71.86±5.64) pg/mL vs (52.33±10.66) pg/mL ],差异均有统计学意义(P<0.05);③治疗前,两组患者的TLR-2、TLR-4阳性率比较差异无统计学意义(P>0.05),治疗后,两组患者的阳性率均降低,且观察组降低幅度高于对照组(12.50% vs 37.50%、15.63% vs 40.63%),差异均有统计学意义(P<0.05);④观察组患者的肝功能总异常发生率为6.25%,低于对照组的 31.25%,治疗6个月后的复发率为6.25%,低于对照组的 28.13%,差异均有统计学意义(P<0.05)。结论 采用甘草酸制剂强力宁联合曲安奈德治疗UC可减轻患者的炎症反应,促进肠道黏膜修复,疗效高且安全。
      【关键词】 溃疡性结肠炎;曲安奈德;强力宁;高迁移率族蛋白B1;Toll样受体
      【中图分类号】 R574.62 【文献标识码】 A 【文章编号】 1003—6350(2018)01—0033—04
Effects of potenline (glycyrrhizin) combined with triamcinolone acetonide on peripheral blood high-mobility groupB1, Toll-like receptors and liver function in patients with ulcerative colitis. HAN Zhen-zhong, WAMG Jun, ZHANGHong-bo. Department of Digestive Endocrinology, the Northern Hospital of Xi'an City, Xi'an 710043, Shaanxi, CHINA
      【Abstract】 Objective To investigate the effects of potenline (glycyrrhizin) combined with triamcinolone ace-tonide on peripheral blood high-mobility group B1 (HMGB1), Toll-like receptors (TLRs) and liver function in patientswith ulcerative colitis (UC). Methods A total of 64 cases of patients with UC, who admitted to Department of Diges-tive Endocrinology of the Northern Hospital of Xi'an City from March 2011 to February 2015, were selected and dividedinto the control group and the observation group by random number table method, with 32 cases in each group. The con-trol group was treated with triamcinolone acetonide, and the observation group was additionally treated with glycyrrhizinpotenline on the basis of the treatment of the control group. Both groups received 4 weeks of treatment. Peripheral bloodwas collected before and after the treatment to determine the levels of HMGB1, interleukin-6 (IL-6) and interleukin-10(IL-10). The colon tissue samples were collected to detect the positive rate of TLR-2 and TLR-4. Liver function wasmonitored during the treatment. The improvement of symptoms and signs was observed, and the effects of clinical treat-ment were recorded. Results ① The total effective rate of the treatment for patients in the observation group was slight-ly higher than that in the control group (87.50% vs 71.88%, P>0.05). ② There was no significant difference in levels ofHMGB1, IL-6 and IL-10 between the two groups before the treatment (P>0.05). After the treatment, the levels ofHMGB1 and IL-6 were decreased, while IL-10 levels were increased in the two groups compared with those before thetreatment (P<0.05). The levels of HMGB1 and IL-6 after treatment were respectively (2.15±0.21) μg/L and (190.22±20.12) pg/mL in the observation group versus (3.37±0.42) μg/L and (206.11±15.36) pg/mL in the control group, andIL-10 level was (71.86±5.64) pg/mL versus (52.33±10.66) pg/mL in the control group (P<0.05). ③ Before the treat-ment, there was no significant difference in the positive rates of TLR-4 and TLR-2 between the two groups (P>0.05).After the treatment, the positive rates in the two groups were decreased, and the decrease in observation group was great-er than that in the control group (12.50% vs 37.50%, 15.63% vs 40.63%, P<0.05).④ The total incidence of liver functionabnormality in observation group was lower than that in the control group (6.25% vs 31.25%, P<0.05).⑤ The recurrence·论 著·doi:10.3969/j.issn.1003-6350.2018.01.010

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