肝硬化静脉曲张出血内镜治疗后感染对血清25-OH-D3水平的影响  

Influence of endoscopic treatment-induced infection on serum 25-OH-D3of liver cirrhosis patients with variceal bleeding

作　　者：张方宇[1] 徐勇[1] 林廷辉[1] 罗德兰 黄凤 钟宇琼 ZHANG Fang-yu;XU Yong;LIN Ting-hui;LUO De-lan;HUANG Feng;ZHONG Yu-qiong(The First People′s Hospital of Neijiang,Neijiang,Sichuan 641000,China)

机构地区：[1]内江市第一人民医院消化内科,四川内江641000 [2]内江市第一人民医院消化内镜中心,四川内江641000

出　　处：《中华医院感染学杂志》2023年第14期2125-2129,共5页Chinese Journal of Nosocomiology

基　　金：四川省卫生厅科学研究基金资助项目(120031)。

摘　　要：目的探讨肝硬化静脉曲张出血内镜治疗后感染对血清25羟基维生素D3(25-OH-D3)水平的影响。方法回顾性分析2017年2月-2020年9月内江市第一人民医院行内镜治疗的100例肝硬化静脉曲张出血患者资料,按感染情况分为感染组18例和未感染组82例,对比两组血清25-OH-D3水平、维生素D受体(VDR)基因型及等位基因频率,探究内镜治疗后感染的危险因素。结果18例感染患者共检出25株病原菌;感染组VDR AA基因型频率、A等位基因频率均高于未感染组(P<0.05);两组血清白蛋白、25-OH-D3水平比较,差异有统计学意义(P<0.05);Logistic回归分析发现25-OH-D3降低是内镜治疗后感染的危险因素(P<0.05)。结论25-OH-D3降低是肝硬化静脉曲张出血内镜治疗后感染的危险因素,且VDR基因FokⅠ位点多态性与感染有关,等位基因A是其易感基因,可为临床评估及控制感染提供依据。OBJECTIVE To explore the influence of endoscopic treatment-induced infection on serum 25-hydroxyvitamin D3(25-OH-D3)of liver cirrhosis patients with variceal bleeding.METHODS A total of 100liver cirrhosis patients with variceal bleeding who received endoscopic treatment in the First People′s Hospital of Neijiang from Feb 2017to Sep 2020were enrolled in the study,the data of the patients were retrospectively analyzed.The enrolled patients were divided into the infection group with 18cases and the no infection group with 82cases according to the status of infection.The serum 25-OH-D3level and frequencies of genotypes and alleles of vitamin D receptor(VDR)were compared between the two groups,and the risk factors for the endoscopic treatment-induced infection were observed.RESULTS Totally 25strains of pathogens were isolated from the 18patients with infection.The frequencies of VDR AA genotype and A allele of the infection group were significantly higher than those of the no infection group(P<0.05).There were significant differences in the levels of serum albumin and 25-OHD3between the two groups(P<0.05).Logistic regression analysis showed that the decline of 25-OH-D3was the risk factor for the endoscopic treatment-induced infection(P<0.05).CONCLUSION The decline of 25-OH-D3is the risk factor for the endoscopic treatment-induced infection in the liver cirrhosis patients with variceal bleeding.The polymorphism at FokⅠlocus of VDR gene is associated with the infection,the A allele is the susceptible gene,which may provide guidance for clinical assessment and control of the infection.

关 键 词：25羟基维生素D3 维生素D受体 肝硬化 静脉曲张出血 内镜 感染 内镜治疗后感染 

分 类 号：R575.2[医药卫生—消化系统]