溃疡性结肠炎患者辅以外源性维生素D治疗的抗复发作用观察

The effects of exogenous vitamin D treatment on preventing recurrence in patients with ulcerative colitis

目的研究溃疡性结肠炎(ulcerative colitis,UC)患者辅以外源性维生素D治疗的抗复发作用。方法纳入80例UC患者作为研究对象,随机分为对照组和观察组,每组各40例。对照组给予常规治疗,观察组在常规治疗基础上加用维生素D。比较两组治疗效果,随访1年,记录两组复发情况,比较两组治疗前后炎症相关因子表达水平。结果两组治疗结束时总有效率无显著性差异(P>0.05),观察组完全缓解率显著高于对照组(P<0.05)。随访1年,观察组复发率显著低于对照组(P<0.05),复发中位时间显著长于对照组(Log Rank值=7.140,P<0.05)。观察组治疗结束时和末次随访时白介素-17(interleukin-17,IL-17)和白介素-23(interleukin-23,IL-23)水平显著低于治疗前和对照组,防御素-2(human beta-defensin-2,HBD-2)阴性表达率显著高于对照组(P<0.05)。结论外源性维生素D用于UC患者有助于降低复发率,这可能与维生素D抑制IL-17和IL-23水平,以及调控HBD-2表达有关。

Objective To study the effects of exogenous vitamin D treatment on preventing recurrence in patients with ulcerative colitis. Methods 80 patients with ulcerative colitis（UC） were randomly assigned to two groups,with 40 patients in each group. The control group received conventional treatment,and the treatment group was treated with vitamin D in additional to conventional treatment. The two groups were followed up for 1 years. The expression levels of inflammatory related factors were compared between the two groups before and after treatment. The therapeutic effects of the two groups were compared. Results There was no significant difference in the total effective rate between the two groups at the end of treatment（P〈0.05）. The complete remission rate of the treatment group was significantly higher than that of the control group（P〈0.05）. The recurrence rate of the treatment group was significantly lower than that of the control group（P〈0.05）. The median time to recurrence was significantly longer than that of the control group（Log Rank = 7.140,P〈0.05）. The levels of Interleukin-17（IL-17） and Interleukin-23（IL-23） in the treatment group at the end of treatment and at the end of the follow-up were significantly lower than those before treatment and in the control group.The negative expression rate of Human beta-defensin-2（HBD-2） was significantly higher than that of the control group（P〈0.05）.Conclusion Exogenous vitamin D is effective in the treatment of patients with UC,and it can help to reduce the recurrence rate,which may be related to the inhibition of vitamin D on the levels of IL-17 and IL-23,and the regulation of HBD-2 expression.