维生素D缺乏症患儿的炎症性肠病的研究
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摘要
目的探讨维生素D缺乏与儿童炎症性肠病(IBD)的关系。方法选取2017年6月至2018年5月在玉环市第二人民医院和台州市中心医院确诊为IBD的137例患儿作为实验组,另外选取85例在体检中心就诊的3～14岁健康儿童作为对照组。采用高效液相色谱法对两组患儿清晨空腹血液中维生素25(OH)D水平进行检测,并采用改良的Mayo分析法对IBD活动程度进行分析,以了解患儿维生素D缺乏与IBD活动程度的关系。结果①经过粪便化验和大便培养实验确定急性胃肠炎(AG)97例,其中维生素25(OH)D重度缺乏28例(28.87%),轻微缺乏55例(56.70%),而充足者只有14例(14.43%);②实验组维生素25(OH)D为(11.49±4.57)ng/mL,对照组为(22.53±6.33)ng/mL,两组相比差异有统计学意义(t=9.742,P<0.001);③在AG病例中,疾病重度活动患儿28例,维生素25(OH)D为(8.41±5.66)ng/mL;疾病中度活动患儿32例,维生素25(OH)D为(20.44±7.76)ng/mL;疾病轻度活动患儿37例,维生素25(OH)D为(36.37±3.24)ng/mL,两两相比差异均有统计学意义(t=5.447～8.177,均P<0.01)。结论 IBD患儿绝大多数表现出一定的维生素D缺乏症状。维生素D缺乏程度与IBD的活动程度存在一定的关联。儿童适当补充维生素D可能对预防IBD起到一定作用。
Objective To analyze the relationship between vitamin D deficiency and inflammatory bowel disease(IBD) in children. Methods A total of 137 children diagnosed as IBD in Yuhuan Second People's Hospital and Taizhou Central Hospital from June 2017 to May 2018 were enrolled as experimental group. Eighty-five healthy children with non-IBD were selected as control group. High performance liquid chromatography was used to measure the 25(OH)D levels in fasting blood, and the degree of IBD activity was analyzed by modified Mayo analysis to explore the relationship between vitamin D deficiency and the IBD activity in children.Results Ninety-seven cases of acute gastroenteritis(AG) were determined by stool test and stool culture experiment, including 28(28.87 %) cases of severe deficiency of 25-OH vitamin D, 55(56.70%) cases of mild deficiency, and only 14 cases(14.43%) with sufficient 25-OH vitamin D. The average concentration of 25(OH)D in IBD group was 11.49±4.57 ng/mL, while that in the control group was 22.53±6.33 ng/mL. There was significant difference between two groups(t=9.742, P<0.001). In AG group, there were 28 patients with severe disease activity with 25(OH) D content of 8.41±5.66 ng/mL, 32 patients with active activity with 25(OH) D content of 20.44±7.76 ng/mL, and 37 patients with mild activity with 25(OH) D content of 36.37±3.24 ng/mL. The differences in group comparison were significant(t value ranged 5.447-8.177, all P<0.01). Conclusion Most children with IBD show certain symptoms of vitamin D deficiency. There is a certain correlation between the degree of vitamin D deficiency and the activity level of IBD in children. Appropriate supplementation of vitamin D in children may play a role in preventing IBD.
Objective To analyze the relationship between vitamin D deficiency and inflammatory bowel disease(IBD) in children. Methods A total of 137 children diagnosed as IBD in Yuhuan Second People's Hospital and Taizhou Central Hospital from June 2017 to May 2018 were enrolled as experimental group. Eighty-five healthy children with non-IBD were selected as control group. High performance liquid chromatography was used to measure the 25(OH)D levels in fasting blood, and the degree of IBD activity was analyzed by modified Mayo analysis to explore the relationship between vitamin D deficiency and the IBD activity in children.Results Ninety-seven cases of acute gastroenteritis(AG) were determined by stool test and stool culture experiment, including 28(28.87 %) cases of severe deficiency of 25-OH vitamin D, 55(56.70%) cases of mild deficiency, and only 14 cases(14.43%) with sufficient 25-OH vitamin D. The average concentration of 25(OH)D in IBD group was 11.49±4.57 ng/mL, while that in the control group was 22.53±6.33 ng/mL. There was significant difference between two groups(t=9.742, P<0.001). In AG group, there were 28 patients with severe disease activity with 25(OH) D content of 8.41±5.66 ng/mL, 32 patients with active activity with 25(OH) D content of 20.44±7.76 ng/mL, and 37 patients with mild activity with 25(OH) D content of 36.37±3.24 ng/mL. The differences in group comparison were significant(t value ranged 5.447-8.177, all P<0.01). Conclusion Most children with IBD show certain symptoms of vitamin D deficiency. There is a certain correlation between the degree of vitamin D deficiency and the activity level of IBD in children. Appropriate supplementation of vitamin D in children may play a role in preventing IBD.
引文
[1]邹艳,詹孔才,吴明德.肠道菌群检测对溃疡性结肠炎患者肠黏膜内炎症反应、免疫应答的评估价值[J].海南医学院学报,2017,23(18):2484-2487.
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[9]蔚晓霞,刘占举.炎症性肠病患者的肠道菌群分布与血清TNF-α与IL-6水平的相关性[J].现代生物医学进展,2017,17(16):3076-3078.
[10]Wei Z,Yoshihara E.Vitamin D Switches BAF Complexes to Protect β Cells[J].Cell,2018,173(5):1135-1149.
[2]李明超,远孟梦,孙慧清,等.极低出生体重早产儿出生时及母亲维生素D缺乏与支气管肺发育不良关系的研究[J].中国妇幼健康研究,2017,28(8):902-904.
[3]Meeker S,Seamons A.Protective links between vitamin D,inflammatory bowel disease and colon cancer[J].World J Gastroenterol,2016,22(3):933-948.
[4]范圣先,王剑,李幼生.短肠综合征患者维生素D缺乏的研究进展[J].医学研究生学报,2018,31(10):1096-1099.
[5]Durchschein F,Petritsch W,Hammer H F.Diet therapy for inflammatory bowel diseases:the established and the new[J].World J Gastroenterol,2016,22(7):2179-2194.
[6]Mijan M A,Lim B O.Diets,functional foods,and nutraceuticals as alternative therapies for inflammatory bowel disease:present status and future trends[J].World J Gastroenterol,2018,24(25):2673-2685.
[7]Vanherwegen A S,Gysemans C.Regulation of immune function by vitamin d and its use in diseases of immunity[J].Endocrinol Metab Clin North Am,2017,46(4):1061-1094.
[8]庞园园,方莹,周影.维生素D与炎症性肠病的相关性研究进展[J].新医学,2015,46(6):341-345.
[9]蔚晓霞,刘占举.炎症性肠病患者的肠道菌群分布与血清TNF-α与IL-6水平的相关性[J].现代生物医学进展,2017,17(16):3076-3078.
[10]Wei Z,Yoshihara E.Vitamin D Switches BAF Complexes to Protect β Cells[J].Cell,2018,173(5):1135-1149.
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