SLE患者中维生素D水平变化及临床意义

Change of Vitamin D level in SLE patients and its clinical significance

目的检测血清维生素D在初诊系统性红斑狼疮(SLE)患者中的水平变化,并探讨其临床意义。方法采用化学发光免疫分析法,检测2014年5月~2015年8月35例初诊SLE患者(SLE组)和35例健康体检者(对照组)血清中25(OH)D_3的水平,分析25(OH)D_3与SLEDAI评分、肾脏受累、光过敏及SLE患者相关临床指标的相关性。结果 SLE患者血清25(OH)D_3水平较对照组明显降低,差异有统计学意义(t=-3.97,P<0.001),且SLE组25(OH)D_3水平不足与缺乏的发生率明显高于对照组(x^2=11.46,P<0.05),影响因素有肾脏受累、光过敏、抗dsDNA抗体;25(OH)D_3水平与疾病活动性、ESR、IgG、补体C3、尿微量白蛋白、24 h尿蛋白定量相关,P均<0.05;与抗Sm抗体、CRP、IgM、IgA、补体C4无相关性。结论初诊SLE患者血清25(OH)D3水平明显降低,可能参与了SLE的发生、发展,可作为SLE病情活动的预测指标。

Objective To detect the change of vitamin D level in first-diagnosed SLE patients and to discuss its clinical significance.Methods The method of chemiluminescence immunoassay was applied to detect the 25（OH）D3 level in35 SLE patients（SLE group） first diagnosed during May 2014 and August 2015,and 35 healthy volunteers（control group）.The relations of 25（OH）D3 to SLEDAI scores,renal involvement,photosensitization,and clinical indicators of SLE patients were analyzed.Results The serum 25（OH）D3 level in SLE patients was significantly lower than that in the control group（t=-3.97,P〈0.001）.The incidence of insufficient 25（OH）D3 was higher than that in the control group（x^2= 11.46,P〈0.05）,with impacting factors including renal involvement,photosensitization,and anti-dsDNA antibody.The 25（OH）D3 level was related to disease activity,ESR,IgG,complement C3,urine microalbumin,and 24-hour urinary protein quantity（P〈0.05）;and was not related to anti-Sm antibody,CRP,IgM,IgA,and complement C4.Conclusion The 25（OH）D3 level in first-diagnosed SLE patients is significantly reduced,which is probably involved in the development of SLE and can be considered as the predictive index of SLE disease activity.