类风湿关节炎患者血清维生素D水平及其影响因素分析  

Analysis of Serum Vitamin D Levels and Its Influencing Factors in Patients with Rheumatoid Arthritis

作　　者：柯丹[1] 闫蕊[1] 赵学刚[1] 刘晓敏[1] KE Dan;YAN Rui;ZHAO Xue-gang;LIU Xiao-min(Department of Rheumatology and Immunology,Beijing Shunyi Hospital,Beijing 101300,China)

机构地区：[1]北京市顺义区医院风湿免疫科,北京101300

出　　处：《中国食物与营养》2022年第12期83-85,20,共4页Food and Nutrition in China

基　　金：北京市顺义区临床重点专科建设项目(项目编号:2018QJZ07)。

摘　　要：目的:分析类风湿关节炎患者维生素D营养状况,探讨影响维生素D营养状况的影响因素。方法:收集2019年1月—2021年3月在北京市顺义区医院就诊的128例类风湿关节炎患者为研究对象,同期从本院健康体检中心收集128例健康者为对照组。收集患者一般情况,采集患者空腹静脉血,测量血清25羟维生素D3[25(OH)D3]、血沉(ESR)、C反应蛋白(CRP)水平,对患者疼痛和肿胀关节进行专科体格检查,计算DAS28评分。分析类风湿关节炎患者血清25(OH)D3水平,探讨影响25(OH)D3水平的影响因素。结果:类风湿关节炎患者血清25(OH)D3平均水平为(29.43±5.02)ng/mL,不足和缺乏率为77.34%,维生素D不足和缺乏率显著高于健康对照组人群(P<0.05)。性别为女性、年龄越大、DAS评分>3.2分、ESR值越高、日晒时间≤30 min/d、病程越长是类风湿关节炎患者血清低维生素D水平的危险因素。结论:类风湿关节炎患者血清维生素D水平较低,维生素D不足和缺乏率较高,应多关注女性、年龄大、病程长、日晒时间短、疾病活动度高的患者,评估维生素D营养状况,足量补充维生素D。Objective To analyze the nutritional status of vitamin D in patients with rheumatoid arthritis and to explore the factors influencing the nutritional status of vitamin D.Method Totally 128 patients with rheumatoid arthritis attending Shunyi District Hospital in Beijing from January 2019 to March 2021 were collected as study subjects,and 128 healthy individuals from our health screening center were collected as control group during the same period.The general conditions of the patients were collected,fasting venous blood was collected,25(OH)D3,sedimentation(ESR)and C-reactive protein(CRP)levels were measured,specialist physical examination of the patients’painful and swollen joints was performed,and DAS28 scores were calculated.Serum 25(OH)D3levels in patients with rheumatoid arthritis were analyzed to investigate the factors influencing 25(OH)D3levels.Result The mean serum 25(OH)D3level in patients with rheumatoid arthritis was(29.43±5.02)ng/mL,with a deficiency and deficiency rate of 77.34%,and a significantly higher rate of vitamin D deficiency and deficiency than in the healthy control population(P<0.05).Female gender,older age,DAS score>3.2,higher ESR value,sun exposure≤30 min/day,and longer disease duration were risk factors for low serum vitamin D levels in patients with rheumatoid arthritis.Conclusion Patients with rheumatoid arthritis have lower serum vitamin D levels and higher rates of vitamin D insufficiency and deficiency.More attention should be paid to women,older patients,patients with long disease duration,short sun exposure,and high disease activity to assess vitamin D nutritional status and supplement vitamin D in adequate amounts.

关 键 词：类风湿关节炎 维生素D 影响因素 疾病活动度 

分 类 号：R593.22[医药卫生—内科学]