维生素D对多发性硬化发病的影响及相关因素分析

Effects of vitamin D on the incidence of multiple sclerosis and its relationship with related factors

目的调查重庆地区多发性硬化(MS)患者体内维生素D水平,探讨维生素D与多发性硬化发病的相关性。方法检测120例MS患者和52例正常对照组体内血清25(OH)D水平,分别在夏季(8月)和冬季(1月)测定MS患者的血清25(OH)D水平;观察复发-缓解型多发性硬化(RRMS)患者的复发次数,对MS患者进行生活质量和残疾程度评分。结果 MS组患者血清25(OH)D水平明显低于正常对照组(P<0.01);组内比较,继发进展型多发性硬化(SPMS)组及原发进展型多发性硬化(PPMS)组血清25(OH)D水平均明显低于RRMS组(P<0.01或P<0.05)。MS患者在夏季的血清25(OH)D水平明显低于冬季血清25(OH)D水平(P<0.01)。血清25(OH)D水平越低,RRMS患者复发次数越多(P<0.01),MS患者残疾程度越重(P<0.01),生活质量越低(P<0.01)。结论维生素D缺乏可能影响MS的发病和病情进展,进而影响残疾程度和生活质量。

Objective To investigate the level of vitamin D in multiple sclerosis （MS） patients and to the relation- ship of vitamin D with the onset of MS. Methods We measured the 25（OH）D level in serum samples of 120 MS patients and 52 normal controls at the date of case acquisition , in Summer （August） and in winter （January） respectively. We observed the relapse number of relapsing-remitting multiple sclerosis （RRMS） patients. The expanded disability status scale（EDSS） and Multiple Sclerosis Quality Of Life-54 instrument （MSQOL-54） at the date of serum sampling were ac- cessed with each MS patient. Results The 25 （OH） D levels in MS group were significantly lower than that of the con- trol group（P〈0.01）. 25 （OH） D levels in the secondary progressive multiple sclerosis （SPMS） group（P〈0.01）and the primary progressive multiple sclerosis （PPMS） group （P〈0.05） were significantly lower than the RRMS group. The 25 （OH） D levels of MS group in winter were significantly lower than that in summer （P〈0.01）. The lower levels of 25 （OH） D was accompanied with a higher relapses （P〈0.01）, a more severer disability （P〈0.01）, and a more lower quality of life （P〈0.01） in MS patients. Conclusion Vitamin D deficiency may affect the onset and the progression of MS, thereby affecting the severity of disability and quality of life.