溃疡性结肠炎患者血清维生素D水平与炎症反应及预后的关系

Relationship between serum vitamin D level and inflammatory response, prognosis of patients with ulcerative colitis

目的探究溃疡性结肠炎(UC)患者血清维生素D水平与炎症反应及预后的关系。方法选取2016年5月至2020年5月本院收治的UC患者132例作为UC组,另选取同期体检的健康志愿者100名作为对照组。检测两组血清维生素D水平,UC组肠黏膜内NF-κB、TNF-α、ICAM-1的表达水平,评估治疗1个月后的肠黏膜愈合情况,采用ROC曲线分析维生素D对预后的预测价值。结果 UC组血清中维生素D水平低于对照组(P<0.05);UC组中重度患者血清维生素D水平低于轻度及中度患者,肠黏膜内NF-κB、TNF-α、ICAM-1的表达水平高于轻度及中度患者(P<0.05);UC组中维生素D缺乏患者肠黏膜内NF-κB、TNF-α、ICAM-1的表达水平高于维生素D正常及不足患者,治疗1个月后的肠黏膜愈合率低于维生素D正常及不足患者(P<0.05);ROC曲线分析表明,血清维生素D对UC患者的预后具有预测价值。结论 UC患者血清维生素D水平降低与肠黏膜内炎症基因表达升高及治疗预后不佳有关。

Objective To study the relationship between serum vitamin D level and inflammatory response, prognosis of patients with ulcerative colitis(UC). Methods 132 UC patients admitted to our hospital from May 2016 to May 2020 were selected as UC group and 100 healthy volunteers in the same period were selected as control group. The serum vitamin D levels in two groups, the expression levels of NF-κ B, TNF-α and ICAM-1 in UC group were detected. The healing of intestinal mucosa after 1 month of treatment was evaluated. The predictive value of vitamin D on prognosis was analyzed by ROC curve. Results The serum vitamin D level in UC group was lower than that in control group(P<0.05);the serum vitamin D level of severe patients in UC group was lower than that in mild and moderate patients, and the expression levels of NF-κ B, TNF-α and ICAM-1 in intestinal mucosa were higher than those of mild and moderate patients(P<0.05);the expression levels of NF-κ B, TNF-α and ICAM-1 in intestinal mucosa of patients with vitamin D deficiency in UC group were higher than those of patients with normal or insufficient vitamin D, and the intestinal mucosa healing rate after 1 month of treatment was lower than that of patients with normal and insufficient vitamin D(P<0.05). The ROC curve analysis showed that serum vitamin D had predictive value for the prognosis of UC patients. Conclusion The decrease of serum vitamin D level in UC patients relates to the increase of inflammatory gene expression in intestinal mucosa and poor prognosis.