常见自身免疫性疾病患者血清25-羟维生素D水平的差异分析  

Differential analysis of serum 25-hydroxyvitamin D levels in patients with common autoimmune diseases

作　　者：张彪[1] 曾丽娥 卢鑫鑫 黄肖利[1] 陈少婷 梅端容[1] 江华[1] ZHANG Biao;ZENG Li'e;LU Xinxin;HUANG Xiaoli;CHEN Shaoting;MEI Duanrong;JIANG Hua(Department of Clinical Laboratory,Shengli Clinical Medical College of Fujian Medical University/Fujian Provincial Hospital,Fuzhou,Fujian 350001,China;Department of Clinical Laboratory,Affiliated Zhongshan Hospital,Xiamen University,Xiamen,Fujian 361001,China)

机构地区：[1]福建医科大学省立临床医学院/福建省立医院检验科,福建福州350001 [2]厦门大学附属中山医院检验科,福建厦门361001

出　　处：《检验医学与临床》2024年第7期895-899,共5页Laboratory Medicine and Clinic

摘　　要：目的分析常见自身免疫性疾病患者血清25-羟维生素D[25(OH)D]水平差异及25(OH)D水平与其他实验室指标的相关性。方法选取2022年9月至2023年4月于福建省立医院风湿免疫科就诊的自身免疫性疾病患者229例作为试验组,其中系统性红斑狼疮(SLE)58例、类风湿关节炎(RA)45例、干燥综合征(SS)37例、强直性脊柱炎(AS)60例、皮肌炎(DM)14例和系统性硬化症(SSc)15例;选择同期体检健康人群29例作为对照组。收集血清标本,采用高效液相色谱-串联质谱法对血清标本中的25(OH)D进行检测,分析25-羟维生素D_(2)[25(OH)D_(2)]、25-羟维生素D_(3)[25(OH)D_(3)]和总25(OH)D水平在常见自身免疫性疾病患者中的差异;分析总25(OH)D水平与其他实验室指标之间的相关性。结果试验组的血清总25(OH)D水平表现为缺乏或不足的比例总体上高于对照组。试验组的25(OH)D_(3)和总25(OH)D水平低于对照组,差异有统计学意义(P<0.05),试验组各疾病亚组25(OH)D_(3)、总25(OH)D水平比较,差异有统计学意义(P<0.05),SLE组25(OH)D_(3)和总25(OH)D水平最低,与SS组比较,差异有统计学意义(P<0.05)。女性患者的血清25(OH)D_(3)和总25(OH)D水平低于男性患者,差异有统计学意义(P<0.05)。SLE组血清总25(OH)D水平与红细胞沉降率(ESR)、肌酐(CREA)和尿素氮(BUN)呈负相关(P<0.05),RA组血清总25(OH)D水平与类风湿因子(RF)呈负相关(P<0.05),DM组总25(OH)D水平与ESR呈负相关(P<0.05)。结论自身免疫性疾病患者通常表现为维生素D缺乏或不足,且存在性别差异。在不同的自身免疫性疾病患者中血清总25(OH)D水平与ESR、CREA、BUN及RF表现出不同的相关性。Objective To analyze the difference of serum 25-hydroxyvitamin D[25(OH)D]levels in common autoimmune diseases and its correlation with other laboratory indicators.Methods A total of 229 patients with autoimmune diseases in the department of rheumatology and immunology in Fujian Provincial Hospital from September 2022 to April 2023 were selected as the experimental group,including 58 cases of systemic lupus erythematosus(SLE),45 cases of rheumatoid arthritis(RA),37 cases of Sjogren's syndrome(SS),60 cases of ankylosing spondylitis(AS),14 cases of dermatomyositis(DM)and 15 cases of systemic sclerosis(SSc).Twenty-nine healthy subjects undergoing physical examination during the same period were selected as the control group.Serum samples were collected,and the 25(OH)D levels in serum samples were detected by high performance liquid chromatography-tandem mass spectrometry.The differences of 25(OH)D_(2),25(OH)D_(3) and total 25(OH)D levels in the patients with common autoimmune diseases were analyzed.The correlation be tween the total 25(OH)D level and other laboratory indicators was analyzed.Results The proportion of deficient or insufficient serum total 25(OH)D level in the experimental group was generally higher than that in the control group.The 25(OH)D_(3) and total 25(OH)D levels in the experimental group were lower than those in the control group with statistical difference(P<0.05).There were significant differences in the levels of 25(OH)D_(3) and total 25(OH)D among the disease subgroups in the experimental group(P<0.05).In the comparison among all disease subgroups in the experimental group,the 25(OH)D_(3) and total 25(OH)D levels in the SLE group were the lowest and the difference was statistically significant compared with the SS group(P<0.05).The 25(OH)D_(3) and total 25(OH)D levels in the female patients were lower than those in the male patients with statistical difference(P<0.05).The serum 25(OH)D total level in the SLE group was negatively correlated with erythrocyte sedimentation rate(ESR),creatinine(

关 键 词：自身免疫性疾病 25-羟维生素D 相关性 系统性红斑狼疮 类风湿关节炎 干燥综合征 

分 类 号：R593.2[医药卫生—内科学]