类风湿关节炎患者血清25-OH-VD和SPP1水平检测的临床意义  

Study on Clinical Application of 25-Hydroxyvitamin D and Serum Osteopontin in Rheumatoid Arthritis

作　　者：齐进康 刘佳钰 刘丹 曹团平 QI Jin -kang, LIU Jia- yu, LIU Dan,CAO Tuan -ping(Department of Clinical Laboratory, Xi＇ an Workers＇ Sanatorium, Xi＇ an 710100, China; Department of Clinical Laboratory, the Fifth Hospital of Xi ＇ an City, Xi＇ an 710082, China)

机构地区：[1]西安市工人疗养院检验科,西安710100 [2]西安市第五医院检验科,西安710082

出　　处：《现代检验医学杂志》2018年第6期35-37,42,共4页Journal of Modern Laboratory Medicine

基　　金：陕西省社会发展公关项目(2017SF-245);陕西省自然科学基金(2015JM8483;2016JM8147);陕西省中医药管理局科研项目(15-JC025;Lcms057);西安市科技计划项目[201805096YX4SF30(14)];西安市中医药科研项目(2018年项目)

摘　　要：目的探讨类风湿关节炎(RA)病程血清中25-羟维生素D(25-OH-VD)、血清骨桥素(SPP1)水平与疾病病情的意义。方法 2016年1月～2017年12月在西安市第五医院住院的RA患者96例为RA组,健康查体者60例为对照组。酶联免疫吸附试验(ELISA)法检测血清25-OH-VD和SPP1水平。结果对照组与RA组血清25-OH-VD水平(34.62±7.27ng/ml vs 16.22±2.53ng/ml)差异有统计学意义(t=24.65,P=0.017),血清SPP1水平(33.12±4.38ng/ml vs56.71±9.60ng/ml)差异也有统计学意义(t=19.87,P=0.014);RA组血清25-OH-VD与SPP1水平呈负相关(r=-0.39,P=0.034);RA组中病程小于5年与病程大于5年的血清25-OH-VD分别为20.11±2.54ng/ml和12.77±2.39ng/ml,差异有统计学意义(t=38.10,P=0.001);SPP1水平分别为53.27±12.31ng/ml和61.71±8.63ng/ml,差异有统计学意义(t=11.87,P=0.030)。结论监测RA患者25-OH-VD和SPP1水平变化,对提示RA并发骨质疏松具有重要的临床意义。关注系统治疗疾病的同时给予维生素D的合理补充,尤其是长病程RA患者非常重要。Objective To investigate the impact of the level of serum 25-OH-VD and osteopontin （SPP1） on the rheumatoid arthritis （RA） patients. Methods The levels of 25-OH-VD and SPP1 of 60 healthy controls and 96 patients with RA were detected by enzyme-linked immunosorbent assay （ELISA）. Results The average concentration of 25-OH-VD in healthy controls and RA patients was 34.62±7.2 ng/ml and 16.22 ± 2.5 ng/ml respectively, and there was a significant difference between the two groups （ t =24.65, P =0. 017）. The SPP1 concentration in healthy control group and RA group was 33.12 ±4.38 ng/ml and 56.71±9.60 ng/ml respectively,anti there was significant difference between two groups （t =19.87, P= 0. 014）. In 96 patients with RA,there were 64 patients with the course of RA less than 5 years,accounting for 66.6% of the RA group, and the mean 25-OH-VD value was 20.11 ± 2.54 ng/ml. There were 32 cases of RA patients with a course of RA more than 5 years, accounting for 33.3% in RA group, the average value of 25-OH-VD was 12.77 ±2.5 ng/ml, and the concentration of 25-OH-VD in patients with RA course less than 5 years was significantly different from those of patients whose course was greater than 5 years （P〈0.05）. Conclusion There was a significant difference in the concentration of 25-OH- VD, SPP1 in RA patients with different course of RA. Clinicians should pay attention to the rational supplement of vitamin D in the process of treatment of disease, especially for patients with long course of disease. In addition, need to monitor the 25- OH-VD and SPP1 level of RA patients and be alert to the possibility of osteoporosis.

关 键 词：类风湿关节炎 25-羟维生素D 骨桥素1 临床研究 

分 类 号：R593.22[医药卫生—内科学] R392.11[医药卫生—临床医学]