血清25 OHD水平对溃疡性结肠炎患者疾病活动性和生活质量的影响

摘要

Background:It was demonstrated that vitamin D has extensive biological effects,and evidence exists on association between vitamin D and a variety of immune mediated diseases such as inflammatory bowel disease. Aims:To investigate the relationship between serum level of 25-hydroxyvitamin D(25OHD)and disease activity and quality of life in patients with ulcerative colitis( UC). Methods:Serum level of 25OHD was detected by electrochemiluminescence in 50 outpatients/inpatients with UC from Oct. 2015 to Mar. 2016 at the Anhui Provincial Hospital;35 healthy subjects were served as normal controls. CRP,ESR and PLT were determined by routine laboratory tests in UC patients. Disease activity of UC was assessed by improved Mayo score,and Chinese version IBD questionnaire( IBDQ)was employed to assess quality of life. Results:Vitamin D deficiency defined as serum 25OHD ﹤20 ng/mL was detected in 68. 0% of the UC patients. The mean value of serum 25OHD was significantly lower in UC group than in normal control group[(16. 73 ± 8. 83)ng/mL vs.(19. 84 ± 4. 56)ng/mL,P﹤0. 05]. When patients were stratified with disease activity,serum level of 25OHD decreased in the order of remission,mild,moderate and severe active stage(P ﹤0. 05). In UC patients with vitamin D deficiency,the value of CRP,ESR and PLT were significantly increased(P all ﹤0. 05)and the overall score of IBDQ and scores of four dimensions of IBDQ referring to bowel symptom,systemic symptom,emotional function and social function were significantly decreased(P all ﹤0. 05). Spearman and Pearson correlation coefficients analyses showed that serum level of 25OHD was negatively correlated with Mayo score,CRP,ESR and PLT(P all ﹤0. 05),and positively correlated with scores of IBDQ,including overall score and four dimensional scores in UC group( P all ﹤0. 05 ). Conclusions:Vitamin D deficiency occurs frequently in patients with UC and might have a negative impact on disease activity and quality of life.%背景：近年研究发现维生素D具有广泛的生物学效应，参与了包括炎症性肠病在内的多种免疫性疾病的发病过程。目的：研究溃疡性结肠炎（ UC）患者血清25羟维生素D（25OHD）水平与疾病活动性和生活质量的关系。方法：收集2015年10月—2016年3月安徽省立医院门诊和住院UC患者50例，同期35名健康体检者作为正常对照组，以电化学发光法检测血清25OHD水平。UC患者同时检测CRP、ESR和PLT，以改良Mayo评分系统评估疾病活动性，以中文版IBD问卷（ IBDQ）评估患者生活质量。结果：UC组维生素D缺乏（血清25OHD﹤20 ng/mL）检出率为68.0%，血清25OHD水平显著低于正常对照组[（16.73±8.83）ng/mL对（19.84±4.56）ng/mL，P﹤0.05]，并随疾病活动性的升高而逐渐降低（ P﹤0.05）。维生素 D缺乏组 CRP、ESR、PLT均显著高于非维生素 D缺乏组（P均﹤0.05），IBDQ总分以及肠道症状、全身症状、情感功能、社会功能四个维度的评分均显著低于非维生素D缺乏组（P均﹤0.05）。Spearman或Pearson相关系数分析显示，UC组血清25OHD水平与Mayo评分和CRP、ESR、PLT呈显著负相关（P均﹤0.05），与IBDQ总分以及四个维度评分呈显著正相关（P均﹤0.05）。结论：UC患者存在较高的维生素D缺乏率，维生素D缺乏可能对患者的疾病活动性和生活质量产生负面影响。