2022 年第 6 期 第 17 卷

美沙拉秦长期治疗溃疡性结肠炎患者的效果及对结肠黏膜癌相关基因表达的影响

Long-term efficacy of mesalazine on the treatment of ulcerative colitis and its effect on the expression of colon cancer related genes

作者：陈福安1蔡照华2张呈1张碧华1刘俊鹏3张亚同1

英文作者：Chen Fuan1 Cai Zhaohua2 Zhang Cheng1 Zhang Bihua1 Liu Junpeng3 Zhang Yatong1

单位：1北京医院药学部国家老年医学中心中国医学科学院老年医学研究院北京市药物临床风险与个体化应用评价重点实验室，北京100730；2北京市第二医院消化中心及肿瘤科，北京100031；3北京医院心内科国家老年医学中心中国医学科学院老年医学研究院，北京100730

英文单位：1Department of Pharmacy Beijing Hospital National Center of Gerontology Institute of Geriatric Medicine Chinese Academy of Medical Sciences Beijing Key Laboratory of Assessment of Clinical Drugs Risk and Individual Application Beijing 100730 China; 2Department of Digestive Center and Oncology Beijing Second Hospital Beijing 100031 China; 3Department of Cardiology Beijing Hospital National Center of Gerontology Institute of Geriatric Medicine Chinese Academy of Medical Sciences Beijing 100730 China

关键词：美沙拉秦；溃疡性结肠炎；结肠黏膜癌相关基因；炎性因子

英文关键词：Mesalazine;Ulcerativecolitis;Colonicmucosalcancerrelatedgenes;Inflammatoryfactors

• 摘要：

• 目的 分析采用美沙拉秦长期治疗溃疡性结肠炎（UC）患者的效果及对结肠黏膜癌相关基因表达的影响。方法 选取2018年1—12月在北京医院接受长期治疗的86例UC患者纳入研究，采取随机数字表法将其分为观察组、对照组，各43例。对照组使用柳氮磺吡啶肠溶片治疗，观察组使用美沙拉秦药物治疗。比较2组患者治疗2年后的临床疗效，以及治疗前后的疾病活动指数Mayo AI评分、Nancy组织病理评分、结肠黏膜癌相关基因表达［细胞增殖核抗原（Ki-67）、癌胚抗原相关细胞黏附分子1（CEACAM-1）、人B细胞淋巴瘤2样蛋白1（BCL2L1）、CXC趋化因子配体10（CXCL10）］及炎性因子水平［白细胞介素6（IL-6）、IL-8及肿瘤坏死因子α（TNF-α）］。比较2组治疗期间不良反应发生情况。结果 观察组治疗总有效率明显高于对照组［93.0%(40/43)比81.4%(35/43)］，差异有统计学意义（P=0.010）。治疗后2组Mayo AI评分、Nancy组织病理评分、IL-6、IL-8、TNF-α水平均低于治疗前且观察组均明显低于对照组（均P＜0.05）。治疗后，观察组Ki-67、CEACAM-1、BCL2L1、CXCL10基因表达水平均低于治疗前，且观察组均明显低于对照组（均P＜0.05）。观察组治疗期间不良反应总发生率明显低于对照组［11.6%(5/43)比23.3%(10/43)］，差异有统计学意义（P＜0.05）。结论 美沙拉秦长期治疗UC的有效率较高，不良反应较少，且能够有效降低患者Mayo AI评分及Nancy组织病理评分，降低患者结肠黏膜癌Ki-67、CEACAM-1、BCL2L1、CXCL10基因表达及IL-6、IL-8、TNF-α炎性因子水平。

• Objective To analyze the clinical effect of long-term treatment of ulcerative colitis (UC) with mesalazine and its effect on the expression of colon cancer related genes. Methods Eighty-six patients with UC who received long-term treatment in Beijing Hospital from January to December 2018 were included in the study. They were randomly divided into observation group and control group, with 43 cases in each group. The control group was treated with sulfasalazine enteric coated tablets, and the observation group was treated with mesalazine. The clinical efficacy of the two groups after 2 years of treatment, as well as the disease activity index Mayo AI score, Nancy histopathological score, expression of colonic mucosa cancer related genes［cell proliferating nuclear antigen (Ki-67), carcinoembryonic antigen associated cell adhesion molecule-1 (CEACAM-1), human B cell lymphoma-2-like protein 1 (BCL2L1), CXC chemokine ligand 10 (CXCL10)］ and levels of inflammatory factors ［interleukin-6 (IL-6), IL-8 and tumor necrosis factor-α （TNF-α）］ before and after treatment, and adverse reaction were compared. Results   The total effective rate of observation group was significantly higher than that of control group ［93.0%(40/43) vs 81.4%(35/43)］(P=0.010). After treatment, the levels of Mayo AI score, Nancy histopathological score, levels of IL-6, IL-8 and TNF-α in two groups were significantly lower than those before treatment, and the levels in observation group were significantly lower than those in control group (all P＜0.05). After treatment, the gene expression levels of Ki-67, CEACAM-1, BCL2L1 and CXCL10 in observation group were lower than those before treatment, and the levels in observation group were significantly lower than those in control group (all P＜0.05). The total incidence of adverse reactions in observation group was significantly lower than that in control group ［11.6%(5/43) vs 23.3%(10/43)］(P＜0.05). Conclusions  Under the long-term treatment of mesalazine, patients with UC have a higher therapeutic efficiency and fewer adverse reactions. It can effectively reduce the Mayo AI score and Nancy histopathological score of the patients, and reduce expressions of Ki-67 and CEACAM- 1, BCL2L1, CXCL10 gene and inflammatory factor levels of IL-6, IL-8 and TNF-α.