【摘要】 目的探讨克罗恩病患者血清总25羟基维生素D、细胞因子白介素6(IL-6）、白介素8(IL-8）和肿瘤坏死因子α（TNF-α）在克罗恩病不同时期的表达水平以及其与疾病活动指数（CDAI）的相关性。方法选取2018年1月～2020年12月在北京大学深圳医院就诊的克罗恩病患者共100例纳入研究。收集患者的空腹静脉血，检测总25羟基维生素D,IL-6,IL-8和TNF-α水平；采用CDAI评估患者疾病活动情况，并根据CDAI评分将患者分为四组，缓解期21例，轻度活动期32例，中度活动期29例和重度活动期18例。比较CDAI评分不同分期患者的血清总25-羟基维生素D,IL-6,IL-8和TNF-α的表达水平。并进一步分析比较患者CDAI与血清总25-羟基维生素D水平及细胞因子IL-6,IL-8及TNF-α表达水平之间的相关性。结果四组患者血清总25-羟基维生素D及细胞因子IL-6,IL-8和TNF-α的差异均存在统计学意义（F=34.281～128.53，均P<0.05）。缓解期患者血清总25-羟基维生素D (23.49±3.46μg/L),IL-8(86.39±11.23ng/L）和TNF-α（24.05±2.12ng/L）水平高于其他三组（轻度活动期分别为19.47±2.83μg/L,70.48±9.48ng/L,20.59±3.22ng/L；中度活动期14.30±2.64μg/L,65.38±10.91ng/L,17.48±4.12ng/L；重度活动期11.39±3.93μg/L,46.58±12.32ng/L,13.44±3.98ng/L），但IL-6水平（4.37±0.78ng/L）明显低于其他三组（轻度活动期6.48±1.12 ng/L，中度活动期65.38±10.91 ng/L，重度活动期46.58±12.32 ng/L），差异均具有统计学意义（均P<0.05)。采用Spearman相关性分析发现克罗恩病患者CDAI与血清总25-羟基维生素D水平呈负相关（r=-0.691,P<0.05），与细胞因子IL-6水平呈正相关（r=0.889,P<0.05），与IL-8和TNF-α均呈负相关（r=-0.675,-0.658，均P<0.05）。结论不同疾病活动期的克罗恩病患者总25-羟基维生素D和细胞因子水平存在明显差异，患者血清IL-6水平与疾病活动性呈正相关，而总25-羟基维生素D,IL-8和TNF-α水平与疾病活动性呈负相关。更多还原

【Abstract】 Objective To investigate the expression levels of serum total 25-hydroxyvitamin D, cytokines interleukin-6(IL-6),interleukin-8(IL-8) and tumor necrosis factor α(TNF-α) in patients with Crohn’s disease at different stages of Crohn’s disease and their correlation with Crohn’s disease activity index(CDAI). Methods A total of 100 patients with Crohn’s disease who were treated at Peking University Shenzhen Hospital from January 2018 to December 2020 were included in the study. Fasting venous blood of the patients was collected, and the levels of total 25-hydroxyvitamin D, IL-6, IL-8 and TNF-α were determined.Crohn’s disease activity index(CDAI) was used to evaluate patients’ disease activity. According to CDAI score, the patients were divided into four groups, 21 cases in remission stage, 32 cases in mild active stage, 29 cases in moderate active stage, and 18 cases in severe active stage. The expression levels of serum total 25-hydroxyvitamin D, IL-6, IL-8 and TNF-α in patients with different CDAI scores were compared. The correlation between CDAI and serum total 25-hydroxyvitamin D levels and the expression levels of cytokines IL-6, IL-8 and TNF-α was further analyzed and compared. Results There were significant statistical differences in serum total 25-hydroxyvitamin D and cytokines IL-6, IL-8 and TNF-α among 4 groups(F=34.281～128.53,P<0.05). The serum levels of total 25-hydroxyvitamin D(23.49±3.46μg/L), IL-8(86.39±11.23 ng/L) and TNF-α(24.05±2.12 ng/L) in patients in remission stage were significantly higher than those in the other three groups(mild activity stage:19.47±2.83μg/L, 70.48±9.48 ng/L and 20.59±3.22 ng/L. Moderately active stage: 14.30±2.64μg/L, 65.38±10.91 ng/L and 17.48±4.12 ng/L. Severe active stage: 11.39±3.93μg/L and 46.58±12.32 ng/L, 13.44±3.98 ng/L), but the level of IL-6(4.37±0.78 ng/L) was significantly lower than that in the other three groups(6.48±1.12 ng/L in mild active stage,65.38±10.91 ng/L in moderate active stage, 46.58±12.32 ng/L in severe active stage), the differences were statistically significant(all P<0.05). Spearman correlation analysis showed that CDAI was negatively correlated with serum total 25-hydroxyvitamin D(R=-0.691, P<0.05) and positively correlated with cytokine IL-6(r=0.889, P<0.05) in Crohn’s disease patients. And it was significantly negatively correlated with IL-8 and TNF-α(r=-0.675,-0.658, all P<0.05). Conclusion There were significant differences in total 25-hydroxyvitamin D and cytokine levels among patients with Crohn’s disease at different disease activity stages. Serum IL-6 levels were positively correlated with disease activity, while total 25-hydroxyvitamin D, IL-8 and TNF-αlevels were negatively correlated with disease activity.更多还原