CAJ | 학술논문

目的探讨类风湿关节炎(RA)患者血清25-羟维生素D[25-(OH)-D]水平及其临床意义.方法纳入2014年1月至2015年1月首都医科大学附属北京安贞医院未经治疗的RA患者108例(RA组),按疾病活动性评分系统(DAS28)评分分为缓解期组(＜2.6分,42例)和活动期组(＞3.2分,66例);另纳入同期健康体检者49名为对照组.检测血清25-(OH)-D水平,进行组间比较.分析血清25-(OH)-D水平与疾病相关指标的相关性.结果 RA组患者血清25-(OH)-D水平明显低于对照组[(13±7) μg/L比(26±5)μg/L],差异有统计学意义(P＜0.01).RA组患者血清25-(OH)-D水平与C反应蛋白(CRP)、红细胞沉降率(ESR)、DAS28评分呈负相关,(r=-0.361,r=-0.280,r=-0.275,均P＜0.01).活动期组与缓解期组血清25-(OH)-D水平比较差异无统计学意义(P＞0.05).活动期组RA患者血清25-(OH)-D水平与CRP、ESR、DAS28评分呈负相关(r=-0.467,r=-0.245,r=-0.499,均P＜0.05);缓解期组RA患者血清25-(OH)-D水平与CRP、ESR、DAS28评分无相关性(P＞0.05).活动期组女性患者与男性患者血清25-(OH)-D水平差异无统计学意义(P＞0.05);女性患者血清25-(OH)-D水平与CRP、ESR、DAS28呈负相关(r=-0.529,r=-0.373,r=-0.572,均P＜0.05),男性患者无此相关性(P＞0.05).结论 RA患者血清25-(OH)-D水平普遍降低,RA活动期患者,尤其是女性患者血清25-(OH)-D水平与疾病活动呈负相关.血清25-(OH)-D水平可作为活动期RA患者疾病活动性的辅助监测指标.
목적 탐토류풍습관절염(RA)환자혈청25-간유생소D[25-(OH)-D]수평급기림상의의.방법 납입2014년1월지2015년1월수도의과대학부속북경안정의원미경치료적RA환자108례(RA조),안질병활동성평분계통(DAS28)평분분위완해기조(＜2.6분,42례)화활동기조(＞3.2분,66례);령납입동기건강체검자49명위대조조.검측혈청25-(OH)-D수평,진행조간비교.분석혈청25-(OH)-D수평여질병상관지표적상관성.결과 RA조환자혈청25-(OH)-D수평명현저우대조조[(13±7) μg/L비(26±5)μg/L],차이유통계학의의(P＜0.01).RA조환자혈청25-(OH)-D수평여C반응단백(CRP)、홍세포침강솔(ESR)、DAS28평분정부상관,(r=-0.361,r=-0.280,r=-0.275,균P＜0.01).활동기조여완해기조혈청25-(OH)-D수평비교차이무통계학의의(P＞0.05).활동기조RA환자혈청25-(OH)-D수평여CRP、ESR、DAS28평분정부상관(r=-0.467,r=-0.245,r=-0.499,균P＜0.05);완해기조RA환자혈청25-(OH)-D수평여CRP、ESR、DAS28평분무상관성(P＞0.05).활동기조녀성환자여남성환자혈청25-(OH)-D수평차이무통계학의의(P＞0.05);녀성환자혈청25-(OH)-D수평여CRP、ESR、DAS28정부상관(r=-0.529,r=-0.373,r=-0.572,균P＜0.05),남성환자무차상관성(P＞0.05).결론 RA환자혈청25-(OH)-D수평보편강저,RA활동기환자,우기시녀성환자혈청25-(OH)-D수평여질병활동정부상관.혈청25-(OH)-D수평가작위활동기RA환자질병활동성적보조감측지표.
Objective To evaluate the level and clinical siguificance of serum 25-hydroxyvitamin D in patients with rheumatoid arthritis (RA).Methods Totally 108 untreated RA patients (RA group) and 49 healthy people (control group) from January 2014 to January 2015 were enrolled.According to the disease activity score in 28 joints (DAS28),patients in RA group were divided into remission stage group (＜ 2.6 scores,42 cases) and active stage group (＞3.2 scores,66 cases).The levels of serum 25-(OH)-D were measured and compared among groups.The correlations between 25-(OH)-D level and relative indicators were analyzed.Results The level of serum 25-(OH)-D in RA group was significantly lower than that in control group [(13 ±7) μg/L vs (26 ± 5) μg/L] (P ＜ 0.01).There were negative correlations between serum 25-(OH)-D level and C reactive protein (CRP),erythrocyte sedimentation rate (ESR),DAS28 score in RA group (r =-0.361,r =-0.280,r =-0.275,P ＜ 0.01).The level of serum 25-(OH)-D was not significantly different between remission group and active group (P ＞0.05).The serum 25-(OH)-D level was negatively correlated with CRP,ESRandDAS28 score (r=-0.467,r=-0.245,r=-0.499,P＜0.05) in active stage group but not in remission stage group (P ＞0.05).In active stage group,the 25-(OH)-D levels in males and females were not significantly different;it was negatively correlated with CRP,ESR,DAS28 in females (r =-0.529,r =-0.373,r=-0.572,P＜0.05),but not in males in RA patients (P＞0.05).Conclusion The 25-(OH)-D level in serum is reduced in patients with RA and it is negatively correlated with disease activity,especially in female patients;serum 25-(OH)-D level can be as a marker of monitoring the disease activity in RA patients.