原发性干燥综合征患者抑郁与血25羟维生素D缺乏的相关性研究  

Correlation between depression and serum 25-hydroxyvitamin D deficiencyin patients with primary Sj gren ' s syndrome

作　　者：李慧[1] 孟德芳 魏华 刘英[1] LI Hui;MENG Defang;WEI Hua;LIU Ying(Department of Rheumatology,Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan,Shandong 250011,China;不详)

机构地区：[1]山东中医药大学附属医院风湿免疫科,山东济南250011 [2]苏北人民医院风湿免疫科,江苏扬州225002

出　　处：《中华全科医学》2025年第5期756-759,共4页Chinese Journal of General Practice

基　　金：国家中医药管理局第三届国医大师传承工作室及全国名中医传承工作室建设项目(国中医药办人教函[2018]119号);山东省卫生健康委员会齐鲁医派中医学术流派传承项目(鲁卫函[2020]132号);山东省自然科学基金面上项目(ZR2023MH332)。

摘　　要：目的 探讨原发性干燥综合征(pSS)患者抑郁焦虑的发生与25羟维生素D[25(OH)D]缺乏的相关性,为临床早发现及干预提供理论基础。方法 选取苏北人民医院2023年1—6月就诊pSS患者58例及健康对照24例,检测血清25(OH)D水平,实时荧光定量PCR检测外周血单个核细胞维生素D受体(VDR)表达。收集临床指标,抑郁及焦虑分别使用抑郁自评量表(SDS)和焦虑自评量表(SAS)测评,采用多元logistic回归分析研究pSS患者情绪障碍发生的相关影响因素。结果 pSS无情绪障碍者血清25(OH)D水平为62.67(35.82,83.00)ng/mL,合并情绪障碍者为23.03(15.33,60.00)ng/mL,差异有统计学意义(Z=-2.970,P=0.003),其中合并抑郁者较无情绪障碍者显著降低[19.23(13.18,27.54)ng/mL,Z=-3.844,P<0.001]。pSS合并抑郁者VDR水平低于健康对照组(P<0.05)。pSS患者25(OH)D水平与欧洲抗风湿联盟干燥综合征患者报告指数(ESSPRI)评分呈负相关关系(r=-0.473,P<0.01),与总球蛋白、IgG水平呈负相关关系(P<0.05)。25(OH)D缺乏患者抑郁及间质性肺病发生率明显增高(P<0.05),且25(OH)D越低、总球蛋白越高、IgG越高,合并抑郁概率升高;25(OH)D(OR=0.958)和IgG(OR=1.268)水平是抑郁发生的独立影响因素(P<0.05)。25(OH)D缺乏患者焦虑发生率无显著增加。结论 pSS患者抑郁与25(OH)D缺乏密切相关,25(OH)D缺乏有助于预测pSS患者抑郁的发生。Objective To investigate the correlation between depression or anxiety and 25-hydroxyvitamin D(25(OH)D)deficiency in patients with primary Sj gren's syndrome(pSS),aiming to provide a theoretical basis for early clinical identification and intervention.Methods A total of 58 pSS patients and 24 age-and sex-matched healthy controls were recruited from Northern Jiangsu People's Hospital from January to June 2023.The levels of serum 25(OH)D were measured.Vitamin D receptor(VDR)expression in peripheral blood mononuclear cells was measured by RT-PCR.Clinical indicators were collected.Self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were used to assess patients'anxiety and depression,respectively.Multiple logistic regression analysis was used to analyze the factors associated with mood disorder occurrence in patients with pSS.Results Serum 25(OH)D levels were significantly different between pSS patients without mood disorders[62.67(35.82,83.00)ng/mL]and those with mood disorders[23.03(15.33,60.00)ng/mL,Z=-2.970,P=0.003].Notably,patients with depression exhibited significantly lower levels[19.23(13.18,27.54)ng/mL]compared to those without mood disorders(Z=-3.844,P<0.001).The VDR levels of pSS patients with depression were significantly decreased than that in the healthy control group(P<0.05).25(OH)D levels were negatively correlated with ESSPRI score(r=-0.473,P<0.01),total globulin and IgG levels(P<0.05).The incidence of depression and interstitial lung disease in pSS patients with 25(OH)D deficiency was significantly increased(P<0.05),and the lower the 25(OH)D level,the higher the total globulin and IgG,the higher the probability of depression(OR>1).25(OH)D(OR=0.958)and IgG(OR=1.268)levels were independent influencing factors for the development of depression(P<0.05).The incidence of anxiety was not statistically increased in patients with 25(OH)D deficiency.Conclusion Depression in pSS patients is closely associated with 25(OH)D deficiency.25(OH)D deficiency may help to predict depression in patients w

关 键 词：原发性干燥综合征 抑郁 焦虑 25羟维生素D 

分 类 号：R593.2[医药卫生—内科学]