大疱性类天疱疮患者血清25-羟基维生素D水平的临床分析  

Clinical analysis of serum 25-(OH) vitamin D levels in patients with bullous pemphigoid

作　　者：畅晓元[1] 刘岩[1] 来学民[1] CHANG Xiao-yuan;LIU Yan;LAI Xue-min(Department of Dermatology,Shenyang Seventh People's Hospital,Shenyang 110003,China)

机构地区：[1]沈阳市第七人民医院皮肤科

出　　处：《实用药物与临床》2019年第12期1262-1265,共4页Practical Pharmacy and Clinical Remedies

基　　金：辽宁省自然科学技术基金(201800892)

摘　　要：目的检测大疱性类天疱疮(Bullous pemphigoid,BP)患者血清25-(OH)D水平,探讨其临床意义。方法2018年3月至2019年5月我院皮肤科收治的50例BP患者纳入观察组,选取同时期入院的年龄和性别相匹配的48例带状疱疹患者作为对照组。检测两组血清25-(OH)D水平,并测定肝功能,血常规,血清钙、磷、镁及碱性磷酸酶。记录观察组患者的BP面积指数评分(Bullous pemphigoid disease area index,BPDAI)及神经系统合并症。比较两组检验结果,分析观察组患者性别、年龄及神经系统合并症对血清25-(OH)D水平的影响,对观察组患者血清25-(OH)D水平与BPDAI评分及其他化验指标的相关性进行分析。结果观察组患者血清25-(OH)D水平、血清钙、白蛋白低于对照组(P<0.05),嗜酸性粒细胞计数高于对照组(P<0.05),两组碱性磷酸酶水平比较差异无统计学意义(P>0.05)。观察组男性、女性患者血清25-(OH)D水平比较差异无统计学意义(P>0.05);年龄<80岁的患者与≥80岁的患者血清25-(OH)D水平比较差异无统计学意义(P>0.05);伴神经系统合并症的患者血清25-(OH)D水平明显低于无神经系统合并症的患者(P<0.05)。观察组患者BPDAI为35~125分,平均(74.0±24.9)分。Pearson相关分析提示,BP患者血清25-(OH)D水平和BPDAI呈负相关(r=-0.49,P<0.01),与血清白蛋白水平呈正相关(r=0.32,P<0.05)。BP患者血清25-(OH)D水平与血清钙、碱性磷酸酶、嗜酸粒细胞计数无相关性。结论BP患者血清25-(OH)D水平降低,尤其伴有神经系统合并症的患者血清25-(OH)D水平下降可能更多见。25-(OH)D水平可能与BP病情严重程度呈负相关,可能与血清白蛋白水平呈正相关。Objective To determine the level of serum 25-(OH)in patients with bullous pemphigoid(BP)and to investigate its clinical significance.Methods Fifty patients with BP hospitalized in our dermatology ward from March 2018 to May 2019 were enrolled as observation group and forty-eight age-and gender-matched patients with herpes zoster served as control.Serum 25-(OH)D levels,hepatic function,blood routine,serum calcium,phosphate,magnesium and alkaline phosphatase were determined.Bullous pemphigoid disease area indexes(BPDAI)and neurological comorbidities were recorded.Laboratory tests data between the two groups were compared.Effects of age,gender and neurological comorbidities on serum 25-(OH)D level of patients in observation group were analyzed.Association between serum 25-(OH)D levels and BPDAI or other laboratory data of patients in observation group was evaluated.Results Serum 25-(OH)D,calcium and albumin levels of observation group were lower than those of control group(P<0.05).Eosinophils count of observation group was higher than that of control group(P<0.05).There was no significant difference in alkaline phosphatase levels between the two groups(P>0.05).In observation group,there was no significant difference in 25-(OH)D levels between the two genders,or between the patients above 80 and those under 80 years old(P>0.05),and those who had neurological comorbidities presented lower 25-(OH)D levels(P<0.05).BPDAI scores of observation group ranged from 35 to 125,averaged 74.0±24.9.Pearson correlation analysis indicated that serum 25-(OH)D level was negatively related to BPDAI(r=-0.49,P<0.01)and positively related to albumin levels(r=0.32,P<0.05),but it was not related to calcium,alkaline phosphatase levels or eosinophils count.Conclusion Serum 25-(OH)D level decrease in BP patients,especially in those with neurological comorbidities.Serum 25-(OH)D level may be negatively related to the severity of disease and positively related to albumin levels.

关 键 词：大疱性类天疱疮 维生素D 相关性分析 BPDAI评分 低白蛋白血症 

分 类 号：R75[医药卫生—皮肤病学与性病学]