补充外源性维生素D对老年溃疡性结肠炎患者氧化-抗氧化失衡、肠道黏膜屏障和临床预后的影响  

Effects of exogenous vitamin D treatment on oxidation-antioxidant imbalance,intestinal mucosal barrier and clinical prognosis in elderly patients with ulcerative colitis

作　　者：陈风慧 王晓华[2] 范春梅[3] Chen Fenghui;Wang Xiaohua;Fan Chunmei(Department of Emergency,Xi＇an XD Group Hospital（Xi＇an 710077)

机构地区：[1]西电集团医院急诊科,西安710077 [2]陕西学前师范学院卫生所,西安710061 [3]陕西省延安市人民医院消化内科,延安716000

出　　处：《陕西医学杂志》2018年第12期1634-1637,共4页Shaanxi Medical Journal

基　　金：陕西省中医药管理局科研项目(15-SCJH028)

摘　　要：目的:观察补充外源性维生素D对老年溃疡性结肠炎(UC)患者氧化-抗氧化失衡、肠道黏膜屏障和临床预后的影响。方法:将82例老年UC患者随机分为观察组(n=40例)和对照组(n=42例),对照组给予美沙拉秦肠溶片治疗,观察组在对照组基础上补充外源性维生素D制剂治疗,疗程均为3个月。记录两组的临床疗效,并观察两组治疗前后改良Mayo评分、氧化应激和肠黏膜屏障指标的变化;记录两组生活质量、复发率。结果:观察组临床疗效显著高于对照组(P<0.05);两组治疗后改良Mayo评分系统单项(排便次数、便血、内镜发现、总体评价)和总分值均显著降低,观察组治疗后以上评分均低于对照组(P<0.05);两组治疗后血清MAD、DAO和D-乳酸水平均显著降低,SOD水平升高,观察组治疗后以上指标均优于对照组(P<0.05)。两组治疗后的炎症性肠病生存质量问卷(IBDQ)中的肠道症状、全身症状、情感功能、社会功能和总评分均显著升高,观察组治疗后以上指标均高于对照组(P<0.05);观察组复发率低于对照组。结论:补充外源性维生素D可显著缓解老年UC患者病情,提高临床疗效,降低复发率,改善生活质量,其机制可能与其促进氧化-抗氧化平衡,保护肠道黏膜屏障有关。Objective： To observe the effects of supplementation of exogenous vitamin D on oxidation-antioxidant imbalance, intestinal mucosa barrier and clinical prognosis in elderly patients with ulcerative colitis （UC）. Methods：82 elderly patients with UC were randomly divided into observation group （ n =40） and control group （ n =42）. The clinical effects of the two groups were recorded and the changes of modified Mayo score, oxidative stress and intestinal mucosal barrier before and after treatment were observed. Quality of life and recurrence rates were recorded in both groups. Results：Clinical efficacy of observation group was significantly higher than those in control group （ P 〈0.05）. After treatment, individual items （defecation times, hemafuria, endoscopic findings, overall evaluation） and total score of two groups were significantly reduced, and above scores of observation group were lower than control group. After treatment, levels of MAD, DAO and d-lactic acid were significantly decreased and SOD level was increased in both groups, and the above indexes were superior to those in the observation group. The intestinal symptoms, systemic symptoms, emotional function, social function and total IBDQ score after treatment in both groups were significantly increased, and the above indicators in the observation group were higher those in control group after treatment （ P 〈0.05）. The recurrence rate of the observation group was lower than that of the control group. Conclusion： Supplementation of exogenous vitamin D can significantly alleviate the condition of elderly patients with UC, improve clinical efficacy, reduce recurrence rate and improve quality of life. The mechanism may be related to promotion of oxidation-antioxidant balance and protection of intestinal mucosa barrier.

关 键 词：结肠炎 溃疡性/治疗 维生素D/治疗应用 氧化性应激 ＠肠道黏膜屏障 预后 

分 类 号：R574.6[医药卫生—消化系统]