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目的:探讨溃疡性结肠炎肠黏膜内Thl型细胞分泌的细胞因子TNF-α、IL-2,Th2型细胞分泌的细胞因子IL-4、IL-10的作用。方法:住院重症溃疡性结肠炎患者30例,男24例,女6例,年龄18-59(平均45±13)岁,全部患者均经电子结肠镜检查及组织学检查确诊,并连续粪培养2次排除细菌感染,同时加除阿米巴肠病,血吸虫病,肠道肿瘤和内分泌疾病,病变部位包括全结肠型15例,乙状结肠9例,直肠型6例;临床类型包括复发型20例,持续型7例和初发型3例,急性期患者均服用强的松30mg,柳氮磺胺嘧啶500mg2次/d.治疗8wk后复查纤维结肠镜.另选健康对照20名,男14名,女6名,年龄22-61(平均43±12)岁,排除胃肠道和内分泌疾病.应用RT-PCR检测溃疡性结肠炎患者黏膜内细胞因子的发达。结果:溃疡性结肠炎患者急性期应用柳氮磺胺吡啶和糖皮质激素可降低TNF-α(急性期1.22±0.02,慢性期0.78±0.08,P<0.01)、IL-2(急性期0.82±0.06,慢性期0.47±0.04,P<0.01)的表达;提高IL-10(急性期0.68±0.03,慢性期0.91±0.02,P<0.01的表达。结论:溃疡性结肠炎患者以分泌Thl细胞因子为主,存在Thl和Th2细胞因子的平衡漂移。提示他们在溃疡性结肠炎的发生发展中起了重要作用。
Objective: To investigate the effects of Th1 cytokines secreted by TNF-α, IL-2 and Th2 cytokines secreted by Th1 type cells in the intestinal mucosa of patients with ulcerative colitis. Methods: Thirty patients with severe ulcerative colitis in hospital were enrolled in this study. There were 24 males and 6 females, aged from 18 to 59 (average 45 ± 13) years old. All patients were confirmed by electronic colonoscopy and histological examination. 2 times excluding bacterial infection, while addition of amoebic enteropathy, schistosomiasis, intestinal cancer and endocrine diseases, lesions include 15 cases of colon-type, sigmoid colon in 9 cases, 6 cases of rectum; clinical type, including 20 cases of recurrent, 7 cases of persistent type and 3 cases of primary type in patients with acute phase were taking prednisone 30mg, sulfasalazine 500mg2 times / d. Review of 8d after treatment of colonoscopy. Alternative health control 20, 14 males and 6 females Name, age 22-61 (average 43 ± 12) years old, excluding gastrointestinal and endocrine diseases.Detection of mucosal cytokines in patients with ulcerative colitis by RT-PCR. Results: Sulfasalazine and glucocorticoid could reduce the levels of TNF-α (1.22 ± 0.02 in acute phase, 0.78 ± 0.08 in chronic phase, P <0.01) and IL-2 in acute phase of ulcerative colitis (0.82 ± 0.06 in acute phase , Chronic phase 0.47 ± 0.04, P <0.01), and increased the expression of IL-10 (acute phase 0.68 ± 0.03, chronic phase 0.91 ± 0.02, P <0.01) .Conclusion: The expression of Thl cytokines in patients with ulcerative colitis is Lord, there is a balance of Thl and Th2 cytokine drift, suggesting that they play an important role in the occurrence and development of ulcerative colitis.