文章摘要

克罗恩病患者体力活动强度与免疫炎症状态及生活质量的相关性

作者: 1赵宝宁, 2杨丽艳, 3齐建丽, 3马月娜, 3王茜姊, 3杨贺庆, 4尹学永
1 秦皇岛市第二医院手术室,河北 秦皇岛 066600
2 秦皇岛市第二医院院长办公室,河北 秦皇岛 066600
3 秦皇岛市第二医院普外科,河北 秦皇岛 066600
4 秦皇岛市第二医院中医科,河北 秦皇岛 066600
通讯: 赵宝宁 Email: zbn18133850999@163.com
DOI: 10.3978/j.issn.2095-6959.2022.12.024
基金: 秦皇岛市卫生健康委员会项目(201902A064)。

摘要

目的:分析克罗恩病(Crohn’s disease,CD)患者体力活动(physical activity,PA)强度与免疫炎症状态及生活质量的相关性,为优化临床决策提供依据。方法:选取2018年1月至2022年3月在秦皇岛市第二医院消化内科就诊的136例CD患者作为研究组,选取同期100例体检者作为对照组。记录两组的临床特征并检测外周血CD4+T淋巴细胞比例、CD8+T淋巴细胞比例、CD4+/CD8+T淋巴细胞比值、辅助性T细胞(helper T cell,Th)17比例、调节性T细胞(T regular cells,Treg)比例、Th17/Treg比值和血清免疫球蛋白(immunoglobulin,Ig)A、IgG、IgM、C反应蛋白(C-reaction protein,CRP)、白细胞介素(interleukin,IL)-6、IL-10、IL-12、IL-35、肿瘤坏死因子(tumor necrosis factor,TNF)-α水平,采用中文版炎症性肠病生活质量量表(Inflammatory Bowel Disease Quality of Life Scale,IBDQ)评价研究组的生活质量,采用中文版国际体力活动短问卷(International Physical Activity Questionnaire-Short,IPAQ-S)评价研究组的PA强度。结果:研究组的PA强度一级15例(11.03%)、二级64例(47.06%)、三级57例(41.91%)。研究组的外周血CD8+T淋巴细胞比例、Th17比例、Th17/Treg比值和血清CRP、IL-6、IL-12、TNF-α水平均高于对照组,差异均有统计学意义(均P<0.05);且研究组PA强度与上述指标均呈负相关(均P<0.05)。研究组外周血CD4+T淋巴细胞比例、CD4+/CD8+T淋巴细胞比值、Treg比例和血清IgA、IgG、IL-10、IL-35水平均低于对照组,差异均有统计学意义(均P<0.05);研究组PA强度与上述指标及IBDQ总分和各维度评分均呈正相关(均P<0.05)。结论:CD患者的PA强度与其免疫功能紊乱、炎症反应上调呈负相关,与其生活质量呈正相关,临床可考虑针对CD患者开展个性化的运动干预,以达到提高疗效、改善生活质量的目的。
关键词: 克罗恩病;体力活动;免疫;炎症;生活质量

Correlation of physical activity intensity with immune inflammatory status and quality of life in patients with Crohn’s disease

Authors: 1ZHAO Baoning, 2YANG Liyan, 3QI Jianli, 3MA Yuena, 3WANG Qianzi, 3YANG Heqing, 4YIN Xueyong
1 Operating Room, Second Hospital of Qinhuangdao, Qinhuangdao Hebei 066600, China
2 Director Office, Second Hospital of Qinhuangdao, Qinhuangdao Hebei 066600, China
3 Department of General Surgery, Second Hospital of Qinhuangdao, Qinhuangdao Hebei 066600, China
4 Department of Traditional Chinese Medicine, Second Hospital of Qinhuangdao, Qinhuangdao Hebei 066600, China

CorrespondingAuthor: ZHAO Baoning Email: zbn18133850999@163.com

DOI: 10.3978/j.issn.2095-6959.2022.12.024

Foundation: This work was supported by the Project of Qinhuangdao Municipal Health Commission, China (201902A064).

Abstract

Objective: To analyze the correlation between physical activity (PA) intensity and immune inflammatory status as well as quality of life in patients with Crohn’s disease (CD), so as to provide research basis for optimizing clinical decision-making. Methods: A total of 136 patients with CD in the Department of Gastroenterology of Second Hospital of Qinhuangdao from January 2018 to March 2022 were selected as a study group, and 100 physical examiners in the same period were selected as a control group. The clinical characteristics and CD4+ T lymphocyte percentage, CD8+ T lymphocyte percentage, CD4+/CD8+ T lymphocyte ratio, helper T cell (Th)17 percentage, regulatory T cell (Treg) percentage, Th17/Treg ratio in peripheral blood, and the serum immunoglobulin (Ig)A, IgG, IgM, C-reactive protein (CRP), interleukin (IL)-6, IL-10, IL-12, IL-35, and tumor necrosis factor (TNF)-α between the 2 groups were analyzed. The Chinese version of Inflammatory Bowel Disease Quality of Life Scale (IBDQ) was evaluated for the patients in the study group, and the Chinese version of International Physical Activity Questionnaire-Short (IPAQ-S) was employed to evaluate the PA intensity of patients in the study group. Results: In the study group, there were 15 cases (11.03%) at grade I, 64 cases (47.06%) at grade II and 57 cases (41.91%) at grade III of  PA intensity. The levels of CD8+ T lymphocyte percentage, Th17 percentage, Th17/Treg ratio in peripheral blood and the serum CRP, IL-6, IL-12, TNF-α levels of the patients in the study group were higher than those in the control group. With the increase of PA intensity of the patients in the study group, the levels of the above indexes gradually decreased, and the differences were statistically significant (all P<0.05). There were negative correlations between PA intensity and the above indexes of the patients in the study group (P<0.05). The CD4+ T lymphocyte percentage, CD4+/CD8+ T lymphocyte ratio, Treg percentage in the peripheral blood, and the serum IgA, IgG, IL-10, and IL-35 were higher than lower in the control group. With the increase of PA intensity of the patients in the study group, the levels of the above indicators and the total score as well as the scores of all dimensions of IBDQ increased gradually, and the differences were statistically significant (all P<0.05). There were positive correlations of PA intensity with the above indexes, the total score, the scores of all dimensions of IBDQ of the patients in the study group (all P<0.05). Conclusion: PA intensity of patients with CD is negatively correlated with immune dysfunction and up-regulation of inflammatory response, and positively correlated with their quality of life. Personalized exercise intervention for CD patients can be considered in clinic, so as to improve the curative effect and quality of life.

Keywords: Crohn’s disease; physical activity; immunity; inflammation; quality of life

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