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目的 分析高压氧(HBO)联合柳氮磺胺吡啶(SASP)治疗对溃疡性结肠炎(UC)患者血清中非对称性二甲基精氨酸(ADMA)及相关炎症细胞因子浓度的影响,并探讨其作用机制.方法 按照治疗方法,将168例UC患者分为2组,其中对照组78例,仅口服SASP治疗;HBO综合治疗组90例,使用HBO与口服SASP进行综合治疗.通过观察患者临床症状变化并结合内镜检查,评价其临床疗效;定量分析2组患者血清内ADMA与相关炎症细胞因子,肿瘤坏死因子-α(TNF-α)、白细胞介素-2(IL-2)、IL-4、IL-6及IL-10的浓度水平,并对各因素之间的相关性进行统计学分析.结果 HBO综合治疗组(95.56％)临床疗效显著优于对照组(64.10％)(P＜0.05).患者治疗后血清内ADMA、TNF-α、IL-2及IL-6浓度水平[(0.51±0.23、0.48 ±0.17、0.44±0.16、0.30±0.11)μmol/L]均显著低于对照组[(0.85±0.31、0.84 ±0.25、0.68±0.28、0.39 ±0.15) μmol/L],而抗炎细胞因子IL-10浓度水平则显著高于对照组(P＜0.05),但抗炎因子IL-4浓度水平无统计学意义(P＞0.05).ADMA浓度水平与TNF-α、IL-2极显著正相关(P＜0.01);而IL-6浓度水平与抗炎因子IL-10则显著负相关(P＜0.05).结论 HBO联合SASP综合治疗显著降低了UC患者血清内ADMA及炎症细胞因子(TNF-α、IL-2、IL-6)水平,并提高机体抗炎细胞因子IL-10水平,可能是其治疗UC的作用机制之一.

Objective To study the effects of hyperbaric oxygen (HBO) coupled with salicylazosulfapyridine (SASP) on the levels of asymmetrical dimethylarginine (ADMA) and related inflammatory factors in ulcerative colitis (UC) patients,and also to explore the possible mechanism involved.Methods One hundred and sixty-eight cases of UC were divided into the control group (n =78) and the comprehensive treatment group (n =90).The former just received oral SASP,while the latter was treated comprehensively with SASP plus HBO.Changes in clinical symptoms and therapeutic efficacy of the 2 groups were evaluated by close observation of the symptom changes and colonoscopy.The levels of ADMA and related inflammatory factors including TNF-o,IL-2,IL-4,IL-6 and IL-10 in the plasma were quantitatively analyzed for the 2 groups.Additionally,the association between various factors was also statistically analyzed.Results The therapeutic efficacy of the comprehensive HBO group (95.56％) was significantly superior to that of the control group(64.10％ (P ＜ 0.05).Following treatment,the levels of ADMA,TNF-α,IL-2 and IL-6 [(0.51 ±0.23、0.48 ±0.17、0.44 ±0.16、0.30 ±0.11) μmol/L] in the plasma all significantly decreased,while the level of IL-10 significantly increased,as compared with those of the control group [(0.85 ±0.31、0.84 ± 0.25、0.68 ± 0.28、0.39 ± 0.15) μmol/L] (P ＜ 0.05).However,there was no statistical significance in IL-4,when comparisons were made between them.The level of ADMA was positively correlated with TNF-α and IL-2 (P ＜ 0.01),whereas the level IL-6 was negatively correlated with IL-10 (P ＜ 0.05).Conclusions HBO coupled with SASP could significantly decrease the levels of ADMA and related inflammatory factors (TNF-o、IL-2 and IL-6) in UC patients,and at the same time increase the level of anti-inflammatory IL-10,which might be one of the mechanisms for the treatment of UC.