Abulitifu Yilihamu, Maimaiti Mierzhati, Zhao Fengcong, Adilijiang Munire, Qian Wen, Zhang Yongping
Department of Infectious Diseases, People's Hospital of Xinjiang Uygur Autonomous Region, No. 91 Tianchi Road, Urumqi, Xinjiang, 830001, China.
Urumqi Friendship Hospital, Urumqi, Xinjiang, China.
BMC Gastroenterol. 2025 Jul 18;25(1):525. doi: 10.1186/s12876-025-04118-0.
To investigate the effectiveness of combining ursodeoxycholic acid (UDCA) and vitamin D (VitD) in treating patients with primary biliary cholangitis (PBC) and its impact on hepatic fibrosis.
A prospective analysis was conducted on 60 treatment-naive PBC patients who were admitted to our Infectious Diseases Department and outpatient clinic from May 2021 to December 2022. All patients were taking UDCA capsules orally for one year and were randomly divided into two groups: UDCA + VitD group, which received UDCA combined with VitD (1200 IU/day) treatment, and the UDCA monotherapy group. After one year of treatment, the UDCA monotherapy group was then further stratified into two subgroups using the same method, and treatment was extended for an additional year, to further verify the role of VitD in the treatment of PBC with UDCA. Clinical manifestations, blood tests, and imaging tests were collected before and after treatment. The efficacy was evaluated using the Paris I and Barcelona standards, and the improvement of liver stiffness value was assessed according to the liver stiffness measurement (LSM) using FibroTouch.
After one year of treatment, the UDCA + VitD group showed statistically significant decreases in AST, GGT, ALP, Tbil, PT, INR, IgM and LSM levels, and increases in ALB and 25(OH)D levels compared to the UDCA monotherapy group. The 25(OH)D levels had a negative correlation with LSM levels. Additionally, 80.0% of patients in the UDCA + VitD group responded according to the Paris I criteria, while 86.7% responded according to the Barcelona criteria, 50.0% of patients in the UDCA monotherapy group responded according to the Paris I criteria and 63.3% responded according to the Barcelona criteria. The response rate in the UDCA + VitD group was higher than that in the UDCA monotherapy group under both criteria. In the second year of the study after the second randomization, 86.7% of patients responded according to the Paris I criteria in the UDCA + VitD subgroup, while 93.3% responded according to the Barcelona criteria. 53.3% of patients in the UDCA monotherapy subgroup responded according to the Paris I criteria and 66.7% according to the Barcelona criteria. The UDCA + VitD subgroup had a higher Paris I response rate compared with the UDCA monotherapy subgroup.
The combination of UDCA and VitD can increase the drug response rate of UDCA and improve liver function and hepatic fibrosis in PBC patients. VitD may plays an important role in the treatment of PBC.
探讨熊去氧胆酸（UDCA）联合维生素D（VitD）治疗原发性胆汁性胆管炎（PBC）患者的疗效及其对肝纤维化的影响。
对2021年5月至2022年12月入住我院感染科及门诊的60例初治PBC患者进行前瞻性分析。所有患者口服UDCA胶囊1年，随机分为两组：UDCA + VitD组，接受UDCA联合VitD（1200 IU/天）治疗；UDCA单药治疗组。治疗1年后，将UDCA单药治疗组采用相同方法进一步分层为两个亚组，并延长治疗1年，以进一步验证VitD在UDCA治疗PBC中的作用。收集治疗前后的临床表现、血液检查和影像学检查。采用巴黎I标准和巴塞罗那标准评估疗效，使用FibroTouch通过肝脏硬度测量（LSM）评估肝脏硬度值的改善情况。
治疗1年后，与UDCA单药治疗组相比，UDCA + VitD组的AST、GGT、ALP、Tbil、PT（凝血酶原时间）、INR（国际标准化比值）、IgM和LSM水平均有统计学意义的下降，ALB和25(OH)D水平升高。25(OH)D水平与LSM水平呈负相关。此外，UDCA + VitD组80.0%的患者根据巴黎I标准有反应，86.7%的患者根据巴塞罗那标准有反应；UDCA单药治疗组50.0%的患者根据巴黎I标准有反应，63.3%的患者根据巴塞罗那标准有反应。在两种标准下，UDCA + VitD组的反应率均高于UDCA单药治疗组。在第二次随机分组后的研究第二年，UDCA + VitD亚组86.7%的患者根据巴黎I标准有反应，93.3%的患者根据巴塞罗那标准有反应。UDCA单药治疗亚组53.3%的患者根据巴黎I标准有反应，66.7%的患者根据巴塞罗那标准有反应。UDCA + VitD亚组的巴黎I反应率高于UDCA单药治疗亚组。
UDCA与VitD联合应用可提高UDCA的药物反应率，改善PBC患者的肝功能和肝纤维化。VitD可能在PBC治疗中起重要作用。
