选择性白细胞吸附疗法治疗溃疡性结肠炎的疗效及安全性分析

目的探讨选择性白细胞吸附疗法(granulocyte and monocyte adsorption apheresis,GMA)治疗溃疡性结肠炎(ulcerative colitis,UC)的疗效及安全性。方法回顾性收集2018年5月至2019年5月在山东中医药大学第二附属医院行GMA治疗的18例UC患者的临床资料,所有入组患者均行1周2次、5次为1个疗程的治疗方案,重度患者适当延长疗程,分析治疗前、治疗1个疗程后的内镜检查、改良Mayo评分、红细胞沉降率(ESR)、C-反应蛋白(CRP)、白细胞计数(WBC)、中性粒细胞计数(NEUT)、白蛋白(ALB)、血红蛋白(HGB),同时观察患者治疗后的不良反应。结果与治疗前比较,GMA治疗1个疗程结束后,改良Mayo评分、ESR、CRP均显著降低(P<0.05),ALB、HGB均显著升高(P<0.05),WBC、NEUT差异无统计学意义(P>0.05)。18例患者在GMA治疗过程中及治疗后均无明显不良反应发生,安全性良好。结论GMA可明显降低炎症活动度及改善临床症状,且不良反应发生率较低,具有良好的疗效及安全性。

Efficacy and safety of granulocyte and monocyte adsorption apheresis therapy in the treatment of ulcerative colitis

Objective To investigate the efficacy and safety of granulocyte and monocyte adsorption apheresis(GMA)therapy in the treatment of ulcerative colitis(UC).Methods The clinical data of 18 UC patients who received GMA therapy in the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine from May 2018 to May 2019 were collected retrospectively.All patients were treated twice a week and 5 times for one course of treatment,and the treatment for patients in the severe stage was appropriately extended.The results of endoscopy,Mayo score and laboratory indexes of erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),white blood cell count(WBC),neutrophil count(NEUT),albumin(ALB)and hemoglobin(HGB)were analyzed before and after one course of the treatment,respectively.The adverse reactions after the treatment were observed.Results Compared with before treatment,at the end of one course of GMA treatment,the Mayo score,ESR and CRP were decreased significantly(P<0.05).ALB and HGB were significantly increased(P<0.05).However,no statistically significance was found in the indexes of WBC and NEUT(P>0.05).During and after the GMA treatment,none of the 18 patients had significant adverse reactions,which meant the treatment had good safety.Conclusion The GMA therapy can significantly reduce the inflammatory activity and improve the clinical symptoms with high efficacy and safety,and the incidence of adverse reactions is low.