类风湿性关节炎患者血清1,25-二羟基维生素 D3水平及其临床意义
| 作者: |
1吴晓丹,
1沈洪远,
1涂爽,
1张铖泱
1 南京医科大学附属无锡第二人民医院检验科，江苏 无锡 214002 |
| 通讯: |
吴晓丹
Email: wxd19880106@126.com |
| DOI: | 10.3978/j.issn.2095-6959.2020.12.005 |
摘要
目的：探讨类风湿性关节炎(rheumatoid arthritis，RA)患者血清1,25-二羟基维生素D3的水平及其临床意义。方法：选取2018年3月至2019年2月南京医科大学附属无锡第二人民医院(以下简称本院)风湿科150例RA患者作为病例组，根据28个关节的疾病活动度评分(Disease Activity Score in 28 joints，DAS28)标准将RA组再分为缓解组34例、低度组35例、中度组45例和高度组36例，同时收集本院健康体检者100例作为对照组。检测所有受检者血清1,25-二羟基维生素D3的水平，进行组间比较。同时，将RA患者血清1,25-二羟基维生素D3水平分别与性别，年龄，病程，BMI，抗环瓜氨酸肽(cyclic citrullinated peptide，CCP)抗体、类风湿因子(rheumatoid factor，RF)，CRP，ESR，纤维蛋白原(fibrinogen，FIB)，D-二聚体，纤维蛋白(原)降解产物(fibrin/fibrinogen degradation products，FDP)，DAS28评分，视觉模拟评分(visual analogue scale，VAS)及健康评估问卷(health assessment questionnaire，HAQ)评分进行相关性分析。结果：RA患者血清1,25-二羟基维生素D3水平[(11.66±2.37) ng/mL]明显低于对照组[(18.47±3.58) ng/mL，(P<0.01)]。RA缓解组、低度组、中度组、高度组的1,25-二羟基维生素D3水平成逐渐下降趋势，缓解组、低度组分别与中度组、高度组两两比较，差异有统计学意义(P<0.05)，缓解组与低度组相比差异无统计学意义(P>0.05)。RA患者的1,25-二羟基维生素D3水平与其一般临床资料(性别、年龄、病程、BMI指数)没有相关性(P>0.05)；与疾病活动性指标CRP，ESR，FIB，D-二聚体和FDP呈负相关(P<0.05)，与CCP和RF没有相关性(P>0.05)；与DAS28评分、VAS评分和HAQ评分呈负相关(P<0.01)。结论：RA患者血清1,25-二羟基维生素D3水平普遍偏低，且与疾病活动度相关，可作为RA病情活动度的监测指标，对RA的诊疗有指导意义。
关键词：
类风湿性关节炎；1
25-二羟基维生素D3；病情活动度
Serum 1,25-dihydroxyvitamin D3 levels in rheumatoid arthritis patients and its clinical significance
CorrespondingAuthor: WU Xiaodan Email: wxd19880106@126.com
DOI: 10.3978/j.issn.2095-6959.2020.12.005
Abstract
Objective: To investigate serum 1,25-dihydroxyvitamin D3 levels in rheumatoid arthritis (RA) patients and its clinical significance. Methods: From March 2018 to February 2019, 150 patients with RA in the department of rheumatology in our hospital were collected as the case group. According to the Disease Activity Score in 28 joints (DAS28) scoring standard, the RA group was divided into the remission group (34 cases), the low group (35 cases), the moderate group (45 cases) and the high group (36 cases). And the 100 healthy patients in our hospital were collected as the healthy control group. Serum 1,25-dihydroxyvitamin D3 levels were measured for comparison between groups. Serum 1,25-dihydroxyvitamin D3 level in RA patients was used for correlation analysis with gender, age, disease course, BMI, anti-CCP, rheumatoid factor (RF), CRP, ESR, fibrinogen (FIB), D-dimer, fibrin/fibrinogen degradation products (FDP), DAS28 scores, visual analogue scale (VAS) scores and health assessment questionnaire (HAQ) scores. Results: The serum 1,25-dihydroxyvitamin D3 level in RA patients [(11.66±2.37) ng/mL] was significantly lower than that in the healthy control group [(18.47±3.58) ng/mL, P<0.01]. Serum 1,25-dihydroxyvitamin D3 level in the remission group was (13.82±1.48) ng/mL, the low group was 13.39±0.96 ng/mL, the moderate group was (11.09±0.95) ng/mL, and the high group was (8.64±1.57) ng/mL, which showed a gradual decline. The remission group and the low group were respectively compared with the moderate group and the high group, and the difference was statistically significant (P<0.05), while the difference between the remission group and the low group had no significance (P>0.05). The serum 1,25-dihydroxyvitamin D3 level in RA patients was not correlated with the general clinical data (gender, age, disease course, BMI) (P>0.05), but negatively correlated with the disease activity indicators (CRP, ESR, FIB, D-dimer and FDP) (P<0.05), DAS28 scores, VAS scores and HAQ scores (P<0.01), excluding CCP and RF (P>0.05). Conclusion: Serum 1,25-dihydroxyvitamin D3 level in RA patients was generally lower and was correlated with disease activity. It can be used as a monitoring indicator of the RA disease activity and has guiding significance for the diagnosis and treatment of RA.
Keywords：
rheumatoid arthritis; 1
25-dihydroxyvitamin D3; disease activity