血清25-羟-维生素D、白细胞介素23及凝血功能指标与类风湿关节炎病情程度及治疗效果的相关性研究  

Correlations between serum 25-hydroxy vitamin D, interleukin-23, coagulation function indicators and the severity of rheumatoid arthritis and treatment effect

作　　者：刘茹 杨焕丽 张敏杰 Liu Ru;Yang Huanli;Zhang Minjie(Department of General Medicine,Xian Yang Central Hospital,Xianyang 712000,Shaanxi Province,China;Department of Laboratory Medicine,Xian Yang Central Hospital,Xianyang 712000,Shaanxi Province,China)

机构地区：[1]咸阳市中心医院全科医学科,咸阳712000 [2]咸阳市中心医院检验科,咸阳712000

出　　处：《中国基层医药》2024年第7期1037-1042,共6页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨血清25-羟-维生素D[25(OH)D]、白细胞介素23(IL-23)及凝血功能指标与类风湿关节炎(RA)病情程度及临床治疗效果的相关性。方法收集2019年2月至2023年1月在咸阳市中心医院就诊的RA患者56例(RA组), 并以同期在该院体检的健康者56例为对照组, 均检测血清25(OH)D、IL-23及凝血功能指标, 通过28个关节疾病活动性评分(DAS28)进行病情严重程度划分, 并根据治疗后DAS28评分情况进行疗效评级, 比较不同病情严重程度及不同疗效患者间血清25(OH)D、IL-23及凝血功能指标的差异, 进行RA患者治疗无效的危险因素分析。结果 RA组血清25(OH)D水平低于对照组[(21.63±2.29)μg/L比(33.06±3.82)μg/L], 凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)及IL-23、纤维蛋白原(FIB)水平[(46.68±5.01)ng/L、(36.85±3.79)s、(16.81±1.73)s、(5.46±0.58)g/L]均高于对照组(t=19.21、-36.88、-6.19、-11.20、-11.93、均P<0.05);RA组血清25(OH)D水平从高至低依次为稳定组[(30.91±3.12)μg/L]、低活动度组[(24.14±2.56)μg/L]、中活动度组[(18.69±1.93)μg/L]、高活动度组[(15.62±1.63)μg/L], PT、APTT及IL-23、FIB水平从高至低依次为高活动度组[(58.08±6.03)ng/L、(39.92±4.08)s、(18.83±2.01)s、(6.19±0.63)g/L]、中活动度组[(51.25±5.27)ng/L、(37.74±3.91)s、(17.15±1.82)s、(5.74±0.59)g/L]、低活动度组[(41.82±4.63)ng/L、(35.41±3.75)s、(16.24±1.71)s、(5.07±0.54)g/L]、稳定组[(30.67±3.17)ng/L、(33.19±3.42)s、(14.29±1.51)s、(4.56±0.51)g/L], 各组间差异均有统计学意义(F=107.90、72.18、4.98、14.26、20.48, 均P<0.05);治疗无效组血清25(OH)D水平显著低于治疗有效组[(18.90±1.97)μg/L比(22.63±2.34)μg/L], PT、APTT及IL-23、FIB水平均显著高于治疗有效组[(55.21±5.71)g/L、(40.62±4.17)s、(18.56±1.93)s、(6.33±0.69)g/L], 差异均有统计学意义(t=5.49、-7.62、-4.48、-4.46、-6.24, 均P<0.05);IL-23、FIB、PT、APTT为RA患者治疗无效的独立危险因�Objective To investigate the correlations between serum 25-hydroxy vitamin D,interleukin-23(IL-23),coagulation function indicators,and the severity of rheumatoid arthritis(RA)and treatment effect.Methods A total of 56 patients with RA who received treatment at Xianyang Central Hospital between February 2019 and January 2023 were included in the RA group,and an additional 56 healthy participants who concurrently underwent physical examination in the same hospital were included in the control group.Serum levels of 25(OH)D,IL-23,and coagulation function indicators were measured in both groups.The severity of RA was evaluated using the Disease Activity Score in 28 Joints(DAS28).The treatment outcomes were assessed based on post-treatment DAS28 scores.Significant differences in serum 25(OH)D,IL-23,and coagulation function indicators were compared among patients with different degrees of disease severity and treatment outcomes.Furthermore,a thorough analysis was conducted to identify risk factors associated with treatment failure in RA patients.Results The serum 25(OH)D level in the RA group was significantly lower than that in the control group[(21.63±2.29)μg/L vs.(33.06±3.82)μg/L,t=19.21,P<0.05].Prothrombin time(PT),activated partial thromboplastin time(APTT),IL-23,and fibrinogen(FIB)were significantly higher in the RA group[(46.68±5.01)ng/L,(36.85±3.79)seconds,(16.81±1.73)seconds,(5.46±0.58)g/L]compared with the control group(t=-36.88,-6.19,-11.20,-11.93,all P<0.05).The serum 25(OH)D levels decreased significantly,with the highest levels observed in the stable group[(30.91±3.12)μg/L],followed by the low activity group[(24.14±2.56)μg/L],the medium activity group[(18.69±1.93)μg/L],and the lowest levels in the high activity group[(15.62±1.63)μg/L,F=107.90,P<0.05].PT,APTT,IL-23 and FIB levels decreased significantly,with the longest periods or highest levels observed in the high activity group[(58.08±6.03)ng/L,(39.92±4.08)seconds,(18.83±2.01)seconds,(6.19±0.63)g/L,F=72.18,P<0.05],followed by the medi

关 键 词：关节炎 类风湿 25-羟维生素D2 白细胞介素23 凝血酶原时间 部分促凝血酶原时间 疾病严重程度指数 纤维蛋白原 

分 类 号：R593.22[医药卫生—内科学]