初始维生素D水平与初发溃疡性结肠炎患者病情及疗效的相关性研究

Correlation between initial vitamin D level and the initial condition and efficacy of patients with incipient ulcerative colitis

目的探讨初始维生素D水平与初发溃疡性结肠炎(UC)患者病情及疗效的相关性和临床意义。方法选取2017年6月至2020年6月在新疆医科大学第一附属医院诊治的114例初发UC患者作为研究对象,分为维生素D正常组(38例)和维生素D缺乏组(76例),另根据初发UC患者的病情严重程度分为轻度组(20例)、中度组(48例)和重度组(46例),均规范治疗12周。比较治疗前维生素D缺乏组与维生素D正常组的初发病情指标,包括白细胞计数(WBC)、红细胞沉降率(ESR)、血红蛋白、血小板计数(PLT)、C反应蛋白(CRP)及改良Mayo评分,并进一步比较各组治疗前后上述指标的变化幅度。结果维生素D正常组治疗前的CRP、ESR、改良Mayo评分均显著低于维生素D缺乏组,血红蛋白显著高于维生素D缺乏组,差异均有统计学意义(P均<0.05),而两组治疗前的WBC和PLT差异则均无统计学意义(P均>0.05)。对两组初发病情严重程度占比进行分析,结果显示,与维生素D缺乏组相比,维生素D正常组的轻度UC占比升高,重度UC占比降低,差异有统计学意义(P<0.05)。维生素D正常组治疗前后的WBC、ESR、血红蛋白、PLT变化幅度均显著大于维生素D缺乏组,差异均有统计学意义(P均<0.05),而两组的CRP和改良Mayo评分变化幅度差异则均无统计学意义(P均>0.05)。初发病情严重程度轻、中、重度组的初始维生素D水平的差异有统计学意义(P<0.01),轻度组的初始维生素D水平高于中度组和重度组,差异有统计学意义(P<0.05)。结论初始维生素D水平与UC患者的初发病情严重程度及疗效有关。初始维生素D正常的UC患者经过规范化治疗后,疗效较初始维生素D缺乏的UC患者更好。

Objective This paper intends to explore the relationship between the initial vitamin D level and the initial condition and efficacy of patients with incipient ulcerative colitis(UC)and its clinical significance.Methods A total of 114 patients with incipient UC who were diagnosed and treated in the First Affiliated Hospital of Xinjiang Medical University from June 2017 to June 2020 were selected and assigned to the normal vitamin D group(38 cases)and the vitamin D deficiency group(76 cases).Besides,they were also assigned to the mild group(20 cases),the moderate group(48 cases),and the severe group(46 cases)according to the severity of the initial illness.All of the patients were treated with standard treatment for 12 weeks.The initial condition of the vitamin D deficiency group and the normal vitamin D group before and after treatment were compared,including white blood cell count(WBC),erythrocyte sedimentation rate(ESR),hemoglobin,platelet count(PLT),C-reactive protein(CRP),and modified Mayo score.Results The CRP,ESR,and modified Mayo scores of the normal vitamin D group before treatment are significantly lower than those of the vitamin D deficiency group,but the hemoglobin is significantly higher than that of the vitamin D deficiency group,with statistically significant differences(all P<0.05),while there is no statistically significant difference in WBC and PLT between the two groups before treatment(P>0.05).The analysis of the proportion of the severity of the initial illness in the two groups indicates that compared with the vitamin D deficiency group,the proportion of mild UC in the normal vitamin D group increased,but that of severe UC decreased,with a statistically significant difference(P<0.05).The changes in WBC,ESR,hemoglobin,and PLT before and after treatment in the normal vitamin D group are significantly greater than those in the vitamin D deficiency group,with statistically significant differences(P<0.05),However,there is no statistically significant difference in the changes in CRP and modified Mayo scores between the two groups(all P>0.05).The initial level of vitamin D in the mild,the moderate,and the severe groups is statistically significant(P<0.01).The initial vitamin D level in the mild group is higher than that in the moderate and severe groups,with a statistically significant difference(P<0.05).Conclusions The initial vitamin D level is related to the initial condition and efficacy of patients with incipient UC.After standardized treatment,the curative effect of UC patients with normal initial vitamin D is better than that of UC patients with initial vitamin D deficiency.