克罗恩病患者维生素D水平与细胞因子的相关性研究  

Study of the correlation between vitamin D status and cytokine levels in patients with Crohn′s disease

作　　者：陈丹[1] 李骥[1] 张鑫垚 张丽[2] 张瑞丽[2] 邱玲[2] 钱家鸣[1] Chen Dan;Li Ji;Zhang Xinyao;Zhang Li;Zhang Ruili;Qiu Ling;Qian Jiaming(Department of Gastroenterology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Clinical Laboratory,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院消化内科,北京100730 [2]中国医学科学院北京协和医学院北京协和医院检验科,北京100730

出　　处：《中华医学杂志》2020年第10期757-762,共6页National Medical Journal of China

基　　金：中央高校基本科研业务费专项资金(3332018012)。

摘　　要：目的探究克罗恩病(CD)患者血清总25羟维生素D[T-25(OH)D]水平及其与外周血细胞因子白细胞介素6(IL-6)、IL-8及肿瘤坏死因子α(TNF-α)和克罗恩病活动指数(CDAI)之间的相关性。方法回顾性纳入2014年4月至2019年3月收住北京协和医院且行血清T-25(OH)D和细胞因子[IL-6、IL-8和(或)TNF-α]检测的CD患者60例,收集临床资料进行分析。结果60例CD患者中男46例,年龄(34±13)岁;其中缓解期16例(26.7%),活动期44例(73.3%);其血清T-25(OH)D水平为(16.0±7.7)μg/L,其中维生素D充足为16例(26.7%),维生素D不足为24例(40.0%),维生素D缺乏为20例(33.3%)。相关性分析发现,血清T-25(OH)D水平与CDAI(r=-0.363,P=0.004)、IL-6(r=-0.360,P=0.007)、超敏C反应蛋白(hsCRP)(r=-0.272,P=0.043)、红细胞沉降率(ESR)(r=-0.293,P=0.024)水平均呈负相关;而与血清白蛋白(Alb)(r=0.372,P=0.003)、血红蛋白(Hb)(r=0.330,P=0.010)和体质指数(BMI)(r=0.276,P=0.033)呈正相关。在44例活动期CD患者中,23例(52.3%)合并感染,其血清T-25(OH)D水平较CD活动期未合并感染组低[(12.55±7.17)比(17.41±6.49)μg/L,P=0.023]。结论CD患者血清T-25(OH)D水平与CDAI、IL-6及炎症指标均呈负相关,且合并感染的CD活动期患者血清T-25(OH)D水平更低。Objective To investigate the correlations of serum total 25-hydroxyvitamin D(T-25(OH)D)levels with serum cytokine levels including interleukin-6(IL-6),interleukin-8(IL-8)and tumor necrosis factorα(TNF-α)and Crohn′s disease activity index(CDAI)in patients with Crohn′s disease(CD).Methods A total of 60 patients with CD admitted in Peking Union Medical College Hospital from April 2014 to March 2019 who completed the tests for serum T-25(OH)D and cytokines(IL-6,IL-8 and/or TNF-α)were retrospectively enrolled.Clinical data were collected for analysis.Results Among 60 CD patients,there were 46 male patients,and the age was(34±13)years.There were 16 patients(26.7%)in remission and 44 cases(73.3%)in active status.The T-25(OH)D level was(16.0±7.7)μg/L.The prevalence of vitamin D sufficiency,insufficiency and deficiency was 26.7%,40.0%and 33.3%,respectively.Correlation analysis showed that serum T-25(OH)D level was negatively correlated with CDAI(r=-0.363,P=0.004),IL-6 level(r=-0.360,P=0.007),hsCRP level(r=-0.272,P=0.043)and ESR level(r=-0.293,P=0.024),while positively correlated with serum Alb level(r=0.372,P=0.003)、Hb(r=0.330,P=0.010)and BMI(r=0.276,P=0.033).Twenty-three cases(52.3%)of active CD patients accompanied with infection had a lower level of serum T-25(OH)D than those without infection[(12.55±7.17)vs(17.41±6.49)μg/L,P=0.023].Conclusion Serum T-25(OH)D level was negatively correlated with CDAI,serum IL-6 level and inflammatory markers in patients with CD,and it was lower in active CD patients with infection than those without infection.

关 键 词：克罗恩病 维生素D 细胞因子 

分 类 号：R57[医药卫生—消化系统]