维生素D对肝硬化患者炎症及肠道通透性的影响

Effect of Supplementation Vitamin D on Inflammation and Intestinal Permeability in Patients with Liver Cirrhosis

目的探讨维生素D对肝硬化患者炎症及肠道通透性的影响。方法将124例肝硬化患者随机分成观察组和对照组,2组常规治疗相同,观察组给予骨化三醇胶丸(0.25μg·d?1)治疗,比较2组治疗前及治疗后3月炎症指标(TNF-α、IL-6、IL-8)及肠道通透性指标(D-乳酸、内毒素、降钙素原)的差别。结果 2组治疗后TNF-α、IL-6、IL-8均较同组治疗前显著下降,差异均有统计学意义(P<0.05);治疗后,观察组TNF-α、IL-6、IL-8显著低于对照组,差异均有统计学意义(P<0.05);2组治疗后D-乳酸、内毒素、降钙素原均较同组治疗前显著下降,差异均有统计学意义(P<0.05);治疗后,观察组D-乳酸、内毒素、降钙素原显著低于对照组,差异均有统计学意义(P<0.05);2组治疗后谷丙转氨酶、谷草转氨酶、总胆红素、直接胆红素、γ-谷氨酰转移酶和碱性磷酸酶均较同组治疗前显著下降,差异均有统计学意义(P<0.05)。结论补充维生素D可改善肝硬化患者炎症指标和肠道通透性,但对肝功能无明显影响。

OBJECTIVE To explore the effect of supplementation vitamin D on inflammation and intestinal permeability in patients with liver cirrhosis. METHODS One hundred and twenty-four patients with liver cirrhosis were randomly divided into the observed group（n=62） and the control group（n=62）. They all accepted the conventional treatment, but the patients in the observed group were given the treatment of calcitriol soft capsules（0.25 μg·d-1） for 3 months. The difference of the inflammatory indexs（TNF--, IL-6, IL-8） and intestinal permeability indexs（D-lactic acid, endotoxin, procalcitonin） were compared between the two groups before and after treatment. RESULTS The concentrations of TNF-α, IL-6, IL-8 after treatment were significantly lower than that before treatment in both of the two groups（P〈0.05）. After treatment, the concentrations of TNF-α, IL-6, IL-8 in the observed group were significantly lower than that in the control group（P〈0.05）. The concentrations of D-lactic acid, endotoxin, procalcitonin after treatment were significantly lower than that before treatment in both of the two groups（P〈0.05）. After treatment, the concentrations of D-lactic acid, endotoxin, procalcitonin in the observed group were significantly lower than that in the control group（P〈0.05）. After treatment, the concentrations of alanine aminotransferase, aspartate aminotransferase, total bilirubin, direct bilirubin, gamma glutamyl transferase and alkaline phosphatase were significantly lower than that before treatment in both of the two groups（P〈0.05）. CONCLUSION Supplementation vitamin D can improve the inflammatory indexes and intestinal permeability in patients with cirrhosis, but has no significant effect on liver function.