风湿性疾病患者血清25-羟-维生素D水平及临床意义  

Expression and significance of 25-hydroxy vitamin D in rheumatic disease patients

作　　者：李金潺 温鸿雁[1] 李小峰[1] 卫丹丹[1] 

机构地区：[1]山西医科大学第二医院风湿免疫科,太原030001

出　　处：《中华临床医师杂志（电子版）》2015年第10期53-57,共5页Chinese Journal of Clinicians(Electronic Edition)

基　　金：国家自然科学基金(81301532);山西省回国留学人员科研资助项目(2013-118)

摘　　要：目的研究风湿性疾病患者中血清25-羟-维生素D[25(OH)D]水平变化,并探讨其临床意义。方法收集资料完整的风湿性疾病患者(105例)及健康对照者(30例),回顾性分析血清25(OH)D水平、骨密度及相关临床资料,包括原发病、发病年龄、性别、吸烟、饮酒、病程、身高、体重、BMI、红细胞沉降率(ESR)、C反应蛋白(CRP)等,组间均数比较采用独立样本t检验或单因素方差分析,组间等级资料比较采用χ2检验,相关性采用Pearson相关分析。结果 (1)病例组血清25(OH)D水平低于健康对照组(t=-3.19,P<0.05)。(2)血清25(OH)D水平与ESR呈负相关(r=-0.289,P<0.01);骨密度与年龄呈负相关(r=-0.433,P<0.01)。(3)根据骨密度分为骨量正常组、骨量减少组及骨质疏松组,3组间的25(OH)D水平呈依次下降趋势且组间比较差异均有统计学意义(P<0.01)。骨质疏松组血清25(OH)D水平与ESR呈负相关(r=-0.474,P<0.05)。(4)根据血清25(OH)D水平分为正常组、不足组、缺乏组,3组间的25(OH)D水平比较差异有统计学意义(P<0.01)。血清25(OH)D水平不足组血清25(OH)D水平与病程呈负相关(r=-0.846,P<0.01)。(5)女性组血清25(OH)D水平与年龄、体重、ESR、BMI、CRP呈负相关(r值分别为-0.363、-0.367、-0.325、-0.249、-0.264,均P<0.05)。女性血清25(OH)D水平低于男性,2组间差异有统计学意义(t=-4.795,P<0.01)。(6)RA组中,血清25(OH)D水平与年龄、BMI呈负相关(r=-0.781、-0.681,均P<0.05);Sp A组中,血清25(OH)D水平与年龄、病程、身高、ESR呈负相关(r值分别为-0.445、-0.382、-368、-0.331,均P<0.05)。其他CTD组中,血清25(OH)D水平与病程、身高、ESR呈负相关(r值分别为-0.470、-0.444、-0.392,均P<0.05)。结论风湿性疾病患者的血清25(OH)D水平及骨密度在不同分组的情况下,分别与性别、年龄、病程、ESR、体重、BMI等指标具有相关性,提示我们在治疗疾病时补充适当剂量的维生素D可能会起到一定的辅助作用。Objective To explore the expression and significance of 25-hydroxy vitamin D [25（OH）D] in rheumatic disease patients. Methods The level of 25-hydroxy vitamin D, bone mineral density （BMD） test and clinical indicators of autoimmune disease cases （n=105） and healthy controls （n=30） were analyzed retrospectively. Clinical indicators included the primary disease, age, gender, smoking, alcohol consumption, course of the disease, height, weight, BMI, erythrocyte sedimentation rate （ESR）, C-reactive protein （CRP） and so on. t-test and one-way ANOVA test were used for data analysis, and 2＇2 test was used to compare the differences among groups. Pearson correlation test was used for statistical analysis. Results （1）Cases of serum 25（OH）D levels were lower than that of the healthy control group （t=--3.19, P〈0.05）. （2）Serum 25（OH）D levels were negatively correlated with ESR （r=-0.289, P〈0.01）. BMD was negatively correlated with age （r=-0.433, P〈0.01）. （3）BMD was classified into three groups： normal group, osteopenia group and osteoporosis group, and significant differences of serum 25（OH）D levels were found by comparison with each group （P〈0.01）. Osteoporosis serum 25（OI-I）D levels were negatively correlated with ESR （r=-0.474, P〈0.05）. （4）Serum 25（OH）D levels were classified into normal, reduction and deficient groups, and significant differences of serum 25（OH）D levels were found by comparison with each group （P〈0.01）. Serum 25（OH）D levels were negatively correlated with disease duration in the group of reduction serum 25（OH）D levels （r=-0.846, P〈0.01）. （5）Women group＇s serum 25（OH）D levels were negatively correlated with age, body weight, ESR, BMI index and CRP （r values were -0.363, -0.367, -0.325, -0.249, -0.264 respectively, all P〈0.05）. Female group＇s serum 25（OH）D levels were less than those of male＇s group, and significant differences of serum 25（OH）D levels were found b

关 键 词：风湿性疾病 维生素D 骨密度 25-羟-维生素D 临床意义 

分 类 号：R593.21[医药卫生—内科学]