克罗恩病和溃疡性结肠炎食物不耐受的差异分析

Differential Analysis of Food Intolerance Between Crohn's Disease and Ulcerative Colitis

背景:炎症性肠病(IBD)的发生、发展与饮食关系密切,食物不耐受在IBD中的发生情况及其与IBD的关系尚不十分清楚。目的:探讨活动期克罗恩病(CD)和溃疡性结肠炎(UC)患者中食物不耐受的差异。方法:选取2016年1月—2017年11月中南大学湘雅医院确诊的活动期134例CD、67例UC患者和42名正常对照者。以ELISA法检测14种食物的血清特异性IgG,据此评价食物不耐受情况,分析CD和UC患者食物不耐受的差异。结果:CD和UC患者食物不耐受阳性率均显著高于对照组(P <0. 001),CD患者又明显高于UC患者(P <0. 001)。三组间食物不耐受程度相比差异有统计学意义(F=46. 707,P <0. 001)。CD患者4种和6种食物不耐受的发生率均明显高于UC患者(P <0. 001)。与UC患者相比,病变累及结肠的CD患者的食物不耐受率无明显差异(P=0. 100),而累及小肠的CD患者明显升高(P=0. 010)。多元Logistic回归分析显示,食物不耐受≥4种为病变累及小肠的CD的危险因素(P=0. 040)。结论:CD和UC患者的食物不耐受阳性率均明显高于对照组,CD患者食物不耐受发生率高、程度重、种类多,病变累及小肠的CD患者的食物不耐受发生率明显高于结肠型CD和UC患者,食物不耐受≥4种可能为小肠型CD的预测因素。

Background:Diet is closely related to the occurrence,development of inflammatory bowel disease(IBD),yet the incidence of food intolerance in IBD and its relationship with IBD are not fully clear.Aims:To explore the difference in food intolerance in patients with active Crohn’s disease(CD)and ulcerative colitis(UC).Methods:A total of134CD,67UC patients and42healthy controls from January2016to November2017at Xiangya Hospital,Central South University were enrolled.Serum specific IgG for14kinds of food were tested by ELISA to evaluate the food intolerance.Differences in food intolerance between CD and UC patients were analyzed.Results:The positivity rates of food intolerance in CD and UC patients were significantly higher than those in control group(P<0.001),and positivity rate of food intolerance in CD patients was significantly higher than that in UC patients(P<0.001).The difference in severity of food intolerance among the three groups was statistically significant(F=46.707,P<0.001).The incidences of4and6kinds of food intolerance were significantly increased in CD patients than in UC patients(P<0.001).No significant difference in food intolerance was found between colonic CD and UC patients(P=0.100),and food intolerance in small bowel CD patients was significantly higher than that in UC patients(P=0.010).Logistic regression analysis indicated that≥4kinds of food intolerance was the risk factor of small bowel CD(P=0.040).Conclusions:The positivity rate of food intolerance is significantly increased in CD and UC patients than in control group.CD patients have higher incidence,more severe,and more kinds of food intolerance.The incidence of food intolerance in small bowel CD patients is significantly higher than that in colonic CD and UC patients.Food intolerance≥4kinds may be the predictive factor for small bowel CD.