初诊强直性脊柱炎患者维生素D营养状态及其临床意义  

Clinical significance of serum 25-hydroxy-itamin D levels in patients with ankylosing spondylitis before treatment

作　　者：李丽 吴记平[1] LI Li;WU Jiping(Department of Rheumatology,Dongguan People′s Hospital,Guangdong 523000,China)

机构地区：[1]广东省东莞市人民医院风湿科

出　　处：《山西医药杂志》2020年第4期378-381,共4页Shanxi Medical Journal

摘　　要：目的检测初诊强直性脊柱炎(AS)患者血中25-羟基维生素D(25-OHD)水平,并探讨其临床意义。方法收集2016年7月至2017年9月在广东省东莞市人民医院住院的71例初诊AS患者及71名健康对照者的血清,测定其25-OHD浓度;用独立样本t检验分析25-OHD浓度在AS患者组和健康对照组、男性组和女性组、青年组和中老年组、春冬季组和夏秋季组、HLA-B27阳性组和阴性组、疾病活动组和疾病稳定组之间的差异;用Pearson相关分析分析25-OHD水平与年龄、病程、体质量指数(BMI)、红细胞沉降率(ESR)、C反应蛋白(CRP)、Bath强直性脊柱炎疾病活动性指数(BASDAI)及Bath强直性脊柱炎功能指数(BASFI)的相关性。结果AS组患者的血清25-OHD水平为(22±8)ng/mL,明显低于健康对照组的(27±6)ng/mL,差异有统计学意义(P<0.01);青年组患者的血清25-OHD水平为(21±7)ng/mL,明显低于中老年组患者的(27±8)ng/ml,差异有统计学意义(P<0.05);病情活动组患者的血清25-OHD水平为(21±6)ng/mL,明显低于病情稳定组的(39±5)ng/mL,差异有统计学意义(P<0.05);AS患者血清25-OHD水平分别与BASDA(r=-0.73)及BASFI评分(r=-0.94)呈负相关,与年龄(r=0.14)、病程(r=-0.03)、BMI(r=0.17)、ESR(r=0.11)及CRP(r=-0.05)无明显相关性。结论初诊AS患者维生素D缺乏明显,年龄和AS病情活动度是影响维生素D的主要因素,血清25-OHD水平与AS疾病活动度呈负相关。Objective To determine the serum level of 25-hydroxyvitamin D[25-OHD[in ankylosing spondylitis(AS)patients and to assess the association of 25(OH)D with clinical presentations.Methods 25(OH)D levels were detected in 71 cases with AS and 71 healthy controls,The AS patients were hospitalized in Dongguan People′s Hospital from July 2016 to September 2019.Independent sample t test was used to analyze the differences of 25-OHD concentration between AS patients and healthy controls,male and female groups,young and middle-aged groups,spring-winter and summer-autumn groups,HLA-B27 positive and negative groups,disease activity and disease stability groups.Pearson correlation analysis was used to analyze the correlation between 25-OHD concentration and age,course of disease,body mass index,ESR,CRP,disease index of Bath ankylosing spondylitis and functional index of Bath ankylosing spondylitis.Results The levels of 25(OH)D of the AS group was(22±8)ng/mL,which was significantly lower than that of the healthy control group(27±6)ng/mL.The difference was statistically significant(P<0.05);The levels of 25(OH)D of the young group was(21±7)ng/mL,which was significantly lower than that of the middle-aged group(27±9)ng/mL.The difference was statistically significant(P<0.05);The levels of 25(OH)D of patients in the disease activity group was(21±7)ng/mL,which was significantly lower than that in the stable group(39±5)ng/mL,and the difference was statistically significant(P<0.05).Negative correlation was detected between 25(OH)D levels and BASDA(correlation coefficient of-0.73)and BASFI score(correlation coefficient of-0.94),there was no significant correlation between vitamin D and age,disease course,BMI,ESR and CRP.Conclusion Vitamin D deficiency was obvious in patients with AS before treatment.Age and disease activity are factors that influence vitamin D levels.Negative correlation is detected between 25(OH)D level and disease activity.

关 键 词：初诊 脊柱炎 强直性 维生素D 25羟基维生素D 病情活动度 

分 类 号：R593.23[医药卫生—内科学]