目的 探究維得利珠單抗聯(lián)合柳氮磺吡啶治療中重度潰瘍性結腸炎的治療效果。方法 選取2021年8月—2023年8月在北京市第六醫(yī)院治療的潰瘍性結腸炎患者99例，隨機將患者分成對照組（49例）和治療組（50例）。對照組口服柳氮磺吡啶腸溶片，初始劑量為1 g/d，如耐受則提升至2 g，3次/d，病情緩解后降至每1 g/d，2次/d。治療組在對照組基礎上靜脈滴注注射用維得利珠單抗，分別于0、2、6、14周用藥1次，每次取300 mg本品加入生理鹽水250 mL，滴注時長控制在30 min以上。兩組患者治療14周。觀察兩組患者臨床療效，比較治療前后兩組患者臨床癥狀改善時間，潰瘍性結腸炎內(nèi)鏡下嚴重程度指數(shù)（UCEIS）、疾病活動指數(shù)（DAI）和炎癥性腸病生存質量問卷（IBDQ）評分，腸黏膜屏蔽功能指標二胺氧化酶（DAO）、細菌內(nèi)毒素（BE）和β-防御素（β-DF）水平，及血清腸型脂肪酸結合蛋白（I-FABP）、單核細胞趨化蛋白-1（MCP-1）和熱休克蛋白70（HSP70）水平。結果 治療后，對照組和治療組臨床總有效率分別為81.63%和96.00%，兩組比較差異具有統(tǒng)計學意義（P＜0.05）。治療后，治療組患者癥狀的改善時間均要明顯短于對照組（P＜0.05）。治療后，兩組患者UCEIS評分和DAI評分均顯著下降，而IBDQ評分均顯著上升（P＜0.05），且治療組在所有評分的改善上表現(xiàn)更為突出（P＜0.05）。治療后，兩組患者腸黏膜屏蔽功能指標DAO、BE、β-DF、I-FABP和MCP-1水平均顯著降低，而血清HSP70水平均顯著升高（P＜0.05），且治療組在這些指標的改善上表現(xiàn)更為突出（P＜0.05）。結論 維得利珠單抗聯(lián)合柳氮磺吡啶治療中重度潰瘍性結腸炎療效顯著，不僅能夠顯著改善患者臨床癥狀、病情程度和生存質量，同時還能夠改善患者腸黏膜屏蔽功能并促進血清學指標的恢復。

Objective To evaluate the clinical efficacy of vedolizumab combined with sulfasalazine in treatment of moderate to severe ulcerative colitis. Methods Patients (99 cases) with moderate to severe ulcerative colitis in Beijing No.6 Hospital from August 2021 to August 2023 were randomly divided into control (49 cases) and treatment (50 cases) group. Patients in the control group were po administered with Sulfasalazine Enteric-coated Tablets, the initial dose was 1 g/d, if tolerated, increased to 2 g, three times daily, and decreased to 1 g/d after remission, twice daily. Patients in the treatment group were iv administered with Vedolizumab for injection on the basis of the control group, once at weeks 0, 2, 6, and 14 respectively, 300 mg was added into 250 mL of physiological saline, the infusion duration was controlled to more than 30 min. Patients in two groups were treated for 14 weeks. After treatment, the clinical evaluations were evaluated, the clinical symptom improvement time, the scores of UCEIS, DAI and IBDQ, the levels of intestinal mucosal shield function indicators DAO, BE and β-DF, and the levels of serum I-FABP, MCP-1 and HSP70 in two groups before and after treatment were compared. Results After treatment, the total clinical effective rates in the control group and the treatment group were 81.63% and 96.00%, respectively, and the difference between the two groups was statistically significant (P < 0.05). After treatment, the improvement time for patients in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, the UCEIS score and DAI score were significantly decreased significantly in two groups, while the IBDQ score was significantly increased (P < 0.05), and the improvement of scores in the treatment group was more prominent (P < 0.05). After treatment, the levels of intestinal mucosal shielding function indicators DAO, BE, β-DF, I-FABP and MCP-1 in two groups were significantly reduced, while the serum HSP70 levels were significantly increased (P < 0.05), and the treatment group showed more prominent improvement in these indicators (P < 0.05). Conclusion Vidlizumab combined with sulfasalazine has significant efficacy in the treatment of moderate to severe ulcerative colitis. It can not only significantly improve the patient’s clinical symptoms, disease severity and quality of life, but also improve the patient's intestinal mucosa shielding function and promote serological indicators.

R975