标题：维生素D对克隆恩病患者炎症因子及铁调节蛋白的影响

      作者：张秋琴 1，刘懿 2，钟颖 1，徐梅琳 1，左艳 1    1.上海市宝山区仁和医院消化科，上海 200431；2.复旦大学附属华山医院消化科，上海 200040

      卷次： 2020年31卷19期

      【摘要】 目的 探讨维生素D对克隆恩病患者炎症因子及铁调节蛋白的影响。方法 选取上海市宝山区仁和医院消化科和复旦大学附属华山北院消化科2015年7月至2019年10月在门诊治疗的100例克隆恩病患者(每家医院各50例)作为研究对象，选取同期100例健康成年人作为对照，按照随机数表法将克隆恩病患者分为治疗组和常规组，每组50例(每家医院各25例)。常规组给予常规治疗，治疗组在常规治疗的基础上加用维生素D治疗，两组均接受门诊治疗90 d。治疗结束后，比较两组患者的治疗效果以及治疗前后的转铁蛋白、铁蛋白、肠黏膜屏障、血清铁的含量、氧化应激水平及白介素6 (IL-6)、白介素1 (IL-1)、肿瘤坏死因子(TNF-α)及C反应蛋白(CRP)水平。结果 治疗前，两组患者的TNF-α、IL-6、IL-1、CRP、转铁蛋白、铁蛋白、血清丙二醛(MAD)、超氧化物歧化酶(SOD)、二胺氧化酶(DAO)、血清铁及D-乳酸水平比较差异均无统计学意义(P>0.05)；治疗组患者的治疗总有效率为80.0%，明显高于常规组的 48.0%，差异具有统计学意义(P<0.05)；治疗后，治疗组患者的铁蛋白、转铁蛋白、MAD、D-乳酸、TNF-α、DAO及 IL-1、IL-6 和CRP水平明显低于常规组，血清铁、SOD明显高于常规组，差异均具有统计学意义(P<0.05)；健康成年人血 25(OH)D3为(42.52±9.35) ng/mL，明显高于克隆恩病患者的(16.12±3.38) ng/mL，差异具有统计学意义(P<0.05)。结论 克隆恩病患者存在明显的维生素D缺乏，及时补充维生素D可以调节患者的铁调节蛋白及炎症因子水平，促进患者的康复。
      【关键词】 克隆恩病；维生素D；炎症因子；铁调节蛋白；肠黏膜屏障；氧化应激
      【中图分类号】 R574 【文献标识码】 A 【文章编号】 1003—6350（2020）19—2480—04

Effect of vitamin D on inflammatory factors and iron regulatory protein in patients with Crohn's disease.
ZHANGQiu-qin 1, LIU Ye 2, ZHONG Ying 1, XU Mei-lin 1, ZUO Yan 1. 1.Department of Gastroenterology, Baoshan District RenheHospital of Shanghai City, Shanghai 200431, CHINA; 2. Department of Gastroenterology, the Affiliated Huashan Hospital ofFudan University, Shanghai 200040, CHINA
【Abstract】 Objective To explore the effects of vitamin D on inflammatory factors and iron regulatory proteinsin patients with Crohn's disease. Methods A total of 100 patients (50 cases in each hospital) with Crohn's disease, ad-mitted to the Outpatient Department of Gastroenterology, Baoshan District Renhe Hospital of Shanghai City and the Af-filiated Huashan Hospital of Fudan University from July 2015 to October 2019, were selected as the research objects.During the same period, 100 healthy adults were enrolled into the control group. According to random number tablemethod, the patients with Crohn's disease were divided into the treatment group (n=50) and the conventional group (n=50), each with 25 patients from each hospital. The conventional group was given conventional treatment, and the treat-ment group was treated with vitamin D on the basis of conventional treatment. Both groups received 90 days of outpa-tient treatment. After the treatment, the treatment effects of the two groups and the transferrin, ferritin, intestinal mucosalbarrier, serum iron content, oxidative stress level, and interleukin 6 (IL-6), interleukin 1 (IL-1), tumor necrosis factor(TNF-α), and C-reactive protein (CRP) content before and after treatment were compared. Results Before treatment,there were no statistically significant differences in the levels of oxidase (DAO), serum iron, and D-lactic acid, TNF-α,IL-6, IL-1, CRP, transferrin, ferritin, serum malondialdehyde (MAD), superoxide dismutase (SOD), diamine (all P>0.05); the total effective rate of patients in the treatment group was 80.0%, which was significantly higher than 48.0% ofpatients in the conventional group (P<0.05); after treatment, ferritin , transferrin, MAD, D-lactic acid, TNF-α, DAO andIL-1, IL-6 and CRP of patients in the treatment group was significantly lower than those of the conventional group, whileserum iron and SOD of patients in the treatment group was significantly higher than those in the conventional group (all P<0.05); blood 25(OH)D3 of healthy adult was (42.52±9.35) ng/mL, which was significantly higher than (16.12±3.38) ng/mLin Crohn's disease group patients (P<0.05). Conclusion Patients with Crohn's disease have a significant deficiency ofvitamin D, and timely supplementation of vitamin D can adjust the levels of iron regulatory proteins and inflammatoryfactors in patients, and promote patient recovery.
      【Key words】 Crohn's disease; Vitamin D; Inflammatory factors; Iron regulatory protein; Intestinal mucosal barri-er; Oxidative stress