中国临床医生
中國臨床醫生
중국림상의생
JOURNAL OF CHINESE PHYSICIAN
2014年
5期
34-36
,共3页
强直性脊柱炎%25-羟-维生素D%骨保护素%骨特异性碱性磷酸酶%肿瘤坏死因子-α
彊直性脊柱炎%25-羥-維生素D%骨保護素%骨特異性堿性燐痠酶%腫瘤壞死因子-α
강직성척주염%25-간-유생소D%골보호소%골특이성감성린산매%종류배사인자-α
Ankylosing spondylitis%25-hydroxy-vitamin D%bone specific alkaline phosphatase%Osteoprotegerin%Tumor necrosis factor-α
目的观察肿瘤坏死因子α( TNF-α)受体-抗体融合蛋白对强直性脊柱炎( AS)患者血清中25-羟基维生素D[25(OH)D]的影响。方法自身前后对照,留取43例病历资料完整的未接受维生素D剂的AS患者接受 TNF-α受体-抗体融合蛋白治疗12周前后血清样本,采用酶联免疫吸附法检测血清中25(OH)D、骨特异性碱性磷酸酶(BAP)和骨保护素(OPG)水平。结果抗TNF-α治疗后患者VAS评分、晨僵时间等临床及炎症指标显著改善。血25(OH)D 治疗后水平为(47.25±16.06)nmol/L 较治疗前(31.25±11.41) nmol/L升高(P<0.01)；血BAP治疗后水平为(23.37±12.43)μg/L较治疗前(20.12±7.93)μg/L升高(P<0.05)；血清OPG水平没有变化(P>0.05)。血25(OH)D与患者VAS、晨僵时间、AS病情活动性指数、AS功能指数、血沉和C反应蛋白均呈负相关(P<0.05)；而与OPG和BAP水平不相关。结论抗TNF-α拮抗剂治疗AS起效快、临床指标改善明显,但需关注其对骨形成的影响。 AS 患者普遍缺乏25(OH)D,25(OH)D受AS的炎症程度影响,25(OH)D在AS疾病活动时水平降低,病情好转后升高。
目的觀察腫瘤壞死因子α( TNF-α)受體-抗體融閤蛋白對彊直性脊柱炎( AS)患者血清中25-羥基維生素D[25(OH)D]的影響。方法自身前後對照,留取43例病歷資料完整的未接受維生素D劑的AS患者接受 TNF-α受體-抗體融閤蛋白治療12週前後血清樣本,採用酶聯免疫吸附法檢測血清中25(OH)D、骨特異性堿性燐痠酶(BAP)和骨保護素(OPG)水平。結果抗TNF-α治療後患者VAS評分、晨僵時間等臨床及炎癥指標顯著改善。血25(OH)D 治療後水平為(47.25±16.06)nmol/L 較治療前(31.25±11.41) nmol/L升高(P<0.01)；血BAP治療後水平為(23.37±12.43)μg/L較治療前(20.12±7.93)μg/L升高(P<0.05)；血清OPG水平沒有變化(P>0.05)。血25(OH)D與患者VAS、晨僵時間、AS病情活動性指數、AS功能指數、血沉和C反應蛋白均呈負相關(P<0.05)；而與OPG和BAP水平不相關。結論抗TNF-α拮抗劑治療AS起效快、臨床指標改善明顯,但需關註其對骨形成的影響。 AS 患者普遍缺乏25(OH)D,25(OH)D受AS的炎癥程度影響,25(OH)D在AS疾病活動時水平降低,病情好轉後升高。
목적관찰종류배사인자α( TNF-α)수체-항체융합단백대강직성척주염( AS)환자혈청중25-간기유생소D[25(OH)D]적영향。방법자신전후대조,류취43례병력자료완정적미접수유생소D제적AS환자접수 TNF-α수체-항체융합단백치료12주전후혈청양본,채용매련면역흡부법검측혈청중25(OH)D、골특이성감성린산매(BAP)화골보호소(OPG)수평。결과항TNF-α치료후환자VAS평분、신강시간등림상급염증지표현저개선。혈25(OH)D 치료후수평위(47.25±16.06)nmol/L 교치료전(31.25±11.41) nmol/L승고(P<0.01)；혈BAP치료후수평위(23.37±12.43)μg/L교치료전(20.12±7.93)μg/L승고(P<0.05)；혈청OPG수평몰유변화(P>0.05)。혈25(OH)D여환자VAS、신강시간、AS병정활동성지수、AS공능지수、혈침화C반응단백균정부상관(P<0.05)；이여OPG화BAP수평불상관。결론항TNF-α길항제치료AS기효쾌、림상지표개선명현,단수관주기대골형성적영향。 AS 환자보편결핍25(OH)D,25(OH)D수AS적염증정도영향,25(OH)D재AS질병활동시수평강저,병정호전후승고。
Objective To examine clinical significance of levels of serum 25-hydroxy-vitamin D in patients with an-kylosing spondylitis treatment by etanercept relationship between 25-hydroxy-vitamin D and AS disease activity. Method The full medical records of 43 AS patients who did not receive vitamin D agents and treated by TNF-αre-ceptor-IIIgG Fc fusion protein for 12 weeks, and serum samples of them,were collected. Levels of 25(OH)D, BAP and OPG had been detected by enzyme-linked immunosorbent assay were used. Result VAS score, duration of morning stiffness, BASDAI, BASFI, ESR and CRP of AS patients after treatment by etanercept had been improved significantly(P<0. 01). The levels of serum 25(OH)D had been increased from (31. 25±11. 41) nmol/L to (47. 25±16. 06) nmol/L(P<0. 01); the levels of serum BAP had been increased from (20. 12±7. 93)μg/L to (23.37±12.43)μg/L(P<0. 05). Levels of OPG did not change(P>0. 05). There were negative correlations between levels of serum 25 ( OH) D and patient VAS, duration of morning stiffness, BASDAI, BASFI, ESR and CRP(P<0. 05). There were no relations between 25(OH)D and BAP or OPG. Conclusion It was quickly and ef-fectively that treat on AS by TNF-α receptor-IIIgG Fc fusion protein, however it is need to pay close attention to its effects on bone formation. AS patients with a general lack of 25 ( OH) D, serums 25 ( OH) D affected by the degree of inflammation. The levels of 25(OH)D were lower when the diseases were active, increased after they had been improved.
