血清维生素D水平与多发性硬化的临床相关性研究

Clinical correlation between serum Vitamin D levels and multiple sclerosis

目的评估MS患者与健康对照体内血清维生素D3水平,以及影响MS患者预后神经功能缺损的相关因素。方法 86例缓解复发型多发性硬化(RRMS)患者和86例健康对照组随机纳入研究,评估并统计两组性别、年龄、维生素D3水平,记录患者组家族史、发病时间、病程、随诊期间复发情况。在入组时以及6 m后对患者组进行EDSS评分。结果患者组与健康对照组血清维生素D水平分别为14.70±12.49和20.90±13.00(P=0.002),具有显著统计学差异。患者组复发患者与未复发患者血清维生素D水平分别为9.77±7.86和16.83±13.54(P=0.003),具有显著统计学差异。EDSS评分与血清维生素D水平无明显相关性(r=-0.101,P=0.353)。EDSS评分与年龄(r=0.701,P<0.001)、病程(r=0.752,P<0.001)存在显著正相关关系。结论 MS患者血清维生素D水平显著低于健康对照组,同时与复发相关,但血清维生素D水平与患者预后神经功能缺损未显示相关关系。研究提示MS患者年龄越大、病程越长,患者预后越差。

Objective To evaluate serum Vitamin D3 levels in patients with multiple sclerosis（ MS） versus healthy controls,and relative factors influencing prognostic neurological deficit in patients with MS. Methods Sixty-eight patients with relapsing-remitting multiple sclerosis（ RRMS） and 86 healthy controls were randomly enrolled in this study. Both groups were evaluated and analyzed regarding gender,age and Vitamin D3 level. Family history,time of onset,course of disease and recurrence during follow-up were recorded for the patients. Patients were scored by EDSS at baseline and 6months,respectively. Results Serum Vitamin D3 levels were（ 14. 70 ± 12. 49） in the patient group and（ 20. 90 ± 13. 00）in the healthy control group,respectively,with a statistically significant difference（ P = 0. 002）. In the patient group,serum Vitamin D3 levels were（ 9. 77 ± 7. 86） in recurrent and（ 16. 83 ± 13. 54） in non-recurrent patients,respectively,with a statistically significant difference（ P = 0. 003）. There was no significant correlation between EDSS scores and serum Vitamin D levels（ r =- 0. 101,P = 0. 353）. EDSS scores had a significant positive correlation with age and course of disease（ r= 0. 701 vs 0. 752,both P〈 0. 001）. Conclusion Serum vitamin D levels are markedly lower in patients with MS than in healthy controls,and are related to the relapse. However,serum Vitamin D levels show no correlation with prognostic neurological deficit in patients. This study suggests that the older patient with a longer course achieves poorer prognosis.