N3 系脂肪酸干预对炎症性肠病病人复发风险的影响

Effect of N3-series fatty acid intervention on the risk of relapse in patients with inflammatory bowel disease

目的探讨N3系脂肪酸干预对炎症性肠病病人复发风险的影响。方法前瞻性选取2018年1月至2020年5月于沧州市人民医院就诊的炎性肠病病人216例,均接受规范化治疗,按照随机数字表法分为对照组108例,予以常规饮食干预;干预组108例,在对照组基础上予以N3系脂肪酸干预;随访观察12个月,记录两组复发情况,根据病人复发情况分为复发组和非复发组,利用Cox回归分析明确N3系脂肪酸干预对炎性肠病病人复发风险的影响。结果随访12个月,无1例失访,共75例病人出现复发,复发率34.72%;其中干预组30例复发,复发率(27.78%)较对照组45例复发,复发率(41.67%)低(log-rankχ^(2)=6.91,P=0.009);复发组和未复发组C-反应蛋白(CRP)、红细胞沉降率(ESR)、肿瘤坏死因子-α(TNF-α)、氧化三甲胺(TMAO)、粪便钙卫蛋白、吸烟比例比较,差异有统计学意义(P<0.05);Cox回归分析显示:ESR[HR=1.03,95%CI:(1.01,1.05)]、TNF-α[HR=1.05,95%CI:(1.03,1.07)]、粪便钙卫蛋白[HR=1.03,95%CI:(1.02,1.03)]、TMAO[HR=1.38,95%CI:(1.12,1.71)]为炎性肠病复发危险因素(均P<0.05),N3系脂肪酸干预[HR=0.56,95%CI:(0.35,0.90)]为炎性肠病复发风险的保护因素(P<0.05)。结论N3系脂肪酸干预有助于降低炎性肠病病人复发风险。

Objective To explore the effect of N3 fatty acid intervention on the risk of recurrence in patients with inflammatory bowel disease.Methods A total of 216 patients with inflammatory bowel disease who were treated in the People's Hospital of Cangzhou from January 2018 to May 2020 were prospectively selected,and all received standardized treatment.According to the random number table method,patients were assigned into the control group and the intervention group,108 cases in the control group received regular diet intervention;108 cases in the intervention group were treated with N3 fatty acid intervention on the basis of the control group.Follow up for 12 months,and the recurrence of the two groups was recorded.The patients were divided into a recurrence group and a non-recurrence group according to the recurrence.Cox regression analysis was used to determine the effect of N3 fatty acid intervention on the recurrence risk of inflammatory bowel disease patients.Results After 12 months of follow-up,no case was lost to follow-up.A total of 75 patients had recurrence,with a recurrence rate of 34.72%;30 cases in the intervention group recurred,and the recurrence rate(27.78%)was lower than that of the 45 cases in the control group(41.67%)(log-rankχ^(2)=6.91,P=0.009);C-reactive protein(CRP),eryth-rocyte sedimentation rate(ESR),tumor necrosis factor-α(TNF-α),trimethylamine oxide(Trimethylamine N-oxide,TMAO),fecal calprotectin,and smoking ratio were significantly different(P<0.05);Cox regression analysis showed that ESR[HR=1.03,95%CI:(1.01,1.05)],TNF-α[HR=1.05,95%CI:(1.03,1.07)],fecal calprotectin[HR=1.03,95%CI:(1.02,1.03)],TMAO[HR=1.38,95%CI:(1.12,1.71)]were risk factors for recurrence of inflammatory bowel disease(all P<0.05),N3 fatty acid intervention[HR=0.56,95%CI:(0.35,0.90)]was a protective factor for the recurrence of inflammatory bowel disease(P<0.05).Conclusion N3 fatty acid intervention can help reduce the risk of recurrence in patients with inflammatory bowel disease.