补充维生素D3对英夫利昔单抗治疗克罗恩病临床缓解的影响

doi:10.3760/cma.j.cn311367-20210902-00480

科研成果详情

题名	补充维生素D3对英夫利昔单抗治疗克罗恩病临床缓解的影响
其他题名	The effects of vitamin D3 supplementation on clinical remission in patients with Crohn′s disease treated with infliximab
作者	徐缘; 邵晓晓; 胡定元; 林道泼; 蒋益
发表日期	2022
发表期刊	中华消化杂志影响因子和分区
语种	中文
原始文献类型	学术期刊
关键词	Crohn病胆骨化醇英夫利昔单抗缓解诱导
其他关键词	Crohn′s disease ; Cholecalciferol ; Infliximab ; Remission induction
摘要	目的回顾性研究英夫利昔单抗(IFX)治疗过程中补充维生素D3对克罗恩病患者临床缓解的影响。方法通过检索温州医科大学附属第二医院临床资料数据库, 筛选2014年1月至2020年1月于消化内科接受IFX治疗的73例初发型中重度克罗恩病患者, 其中血清25羟维生素D[25(OH)D]水平<50 nmol/L即维生素D缺乏者50例。采用Harvey-Bradshaw指数(HBI)评估克罗恩病疾病活动度。所有患者均接受IFX(5 mg/kg)治疗至少54周, 根据IFX治疗时是否补充维生素D3(125 U/d)分为补充组(37例)、未补充组(36例)。比较补充组患者IFX治疗第54周与IFX治疗前的25(OH)D水平, 以及IFX治疗第54周时补充组与未补充组患者的临床缓解率和HBI下降幅度, 分析克罗恩病患者临床缓解率的影响因素。统计学方法采用配对t检验、独立样本t检验、卡方检验、多元logistic回归分析。结果补充组患者IFX治疗第54周时血清25(OH)D水平高于IFX治疗前[(50.83±15.45) nmol/L比(37.68±16.75) nmol/L], 差异有统计学意义(t=-4.55, P<0.001);补充组患者IFX治疗第54周时, 患者的临床缓解率高于未补充组[83.8%(31/37)比61.1%(22/36)], HBI下降幅度大于未补充组[(7.41±3.00)分比(6.28±2.75)分], 差异均有统计学意义(χ2=4.71, t=2.41;P=0.030、0.023)。多元logistic回归分析结果显示, 补充维生素D3是克罗恩病患者(73例)和维生素D缺乏的克罗恩病患者(50例)临床缓解的独立影响因素(b=-1.67、-1.92, P=0.015、0.019)。结论在IFX治疗的克罗恩病患者中, 补充维生素D3可显著提高临床缓解率, 尤其是维生素D缺乏的克罗恩病患者。
其他摘要	Objective:To retrospectively analyze the effects of vitamin D3 supplementation on clinical remission of patients with Crohn′s disease (CD) in the treatment of infliximab (IFX).Methods:From January 2014 to January 2020, 73 patients with initial moderate to severe CD (50 patients with vitamin D deficiency (the level of serum 25-hydroxyvitamin D (25(OH)D)<50 nmol/L)) receiving IFX treatment at Department of Gastroenterology were screened from the clinical database of the Second Affiliated Hospital of Wenzhou Medical University. Harvey-Bradshaw index (HBI) was applied to evaluate the disease activity of CD patients. All the patients underwent IFX treatment (5 mg/kg) for at least 54 weeks. According to whether vitamin D3 (125 U/d) was supplemented during IFX treatment, the patients were divided into supplemented group ( n=37) and non-supplemented group ( n=36). In supplemented group, the level of 25(OH) D of patients at the 54th week was compared with that before IFX treatment. At the 54th week, the clinical remission rate and decline range of HBI were compared between supplemented group and non-supplemented group. And the influencing factors of clinical remission rate were analyzed in CD patients. Paired t test, independent sample t test, chi-square test and multivariable logistic regression were used for statistical analysis. Results:In supplemented group, the level of serum 25(OH)D at the 54th week was higher than that before IFX treatment ((50.83±15.45) nmol/L vs. (37.68±16.75) nmol/L), and the difference was statistically significant ( t=-4.55, P<0.001). At the 54th week, the clinical remission rate of supplemented group was higher than that of non-supplemented group (83.8%, 31/37 vs. 61.1%, 22/36), the decline range of HBI was larger than that of non-supplemented group (7.41±3.00 vs. 6.28±2.75), and the differences were statistically significant ( χ2=4.71, t=2.41; P=0.030 and 0.023). The results of multivariable logistic regression analysis showed that vitamin D3 supplementation was an independent factor affecting the clinical remission rate in CD patients ( n=73) and the patients with vitamin D deficiency ( n=50) ( b= -1.67 and -1.92 , P=0.015 and 0.019). Conclusions:Vitamin D3 supplementation can significantly improve the clinical remission rate in CD patients with IFX treatment, especially in CD patients with vitamin D deficiency.
资助项目	浙江省自然科学基金（LY17H030011,LY18H030009）;浙江省医药卫生科技计划项目（2021KY802,2021KY803）;浙江省中医药科技计划项目（2019ZB075）;温州市科技计划项目（Y20190603,Y2020011,Y2020281,Y2020282,Y2020285）;贺林院士工作站科研基金（19331101,19331104）
ISSN	0254-1432
卷号	42 期号:02 页码:95-102
DOI	10.3760/cma.j.cn311367-20210902-00480
页数	8
收录类别	CNKI ; 万方 ; 维普 ; 北大核心 ; ISTIC ; CSCD ; PKU
URL	查看原文
CSCD记录号	CSCD:7169285
引用统计
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/53509
专题	第二临床医学院，附属第二医院、育英儿童医院_内科学_消化内科
作者单位	温州医科大学附属第二医院育英儿童医院消化内科
第一作者单位	第二临床医学院，附属第二医院、育英儿童医院_内科学_消化内科
第一作者的第一单位	第二临床医学院，附属第二医院、育英儿童医院_内科学_消化内科
推荐引用方式 GB/T 7714	徐缘,邵晓晓,胡定元,等. 补充维生素D3对英夫利昔单抗治疗克罗恩病临床缓解的影响[J]. 中华消化杂志,2022,42(02):95-102.
APA	徐缘, 邵晓晓, 胡定元, 林道泼, & 蒋益. (2022). 补充维生素D3对英夫利昔单抗治疗克罗恩病临床缓解的影响. 中华消化杂志, 42(02), 95-102.
MLA	徐缘,et al."补充维生素D3对英夫利昔单抗治疗克罗恩病临床缓解的影响".中华消化杂志 42.02(2022):95-102.

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