克罗恩病患者血清25OHD水平及其临床意义

Clinical significance of serum 25OHD level in patients with Crohn's disease

目的:了解克罗恩病(Crohn's disease,CD)患者血清25OHD水平及其与CD相关临床因素的关系.方法:收集2015-11/2016-03在安徽医科大学附属省立医院门诊及住院的CD患者共45例(CD组),健康体检者40例(NC组),用电化学发光法检测CD组及NC组的血清25OHD水平,并进行对比分析;将血清25OHD水平与CD组临床指标进行相关性分析,并分析与血清25OHD水平具有相关性的临床指标对血清25OHD的影响.结果:CD组血清25OHD水平低于NC组(12.17 ng/mL±6.12 ng/mL vs 19.56 ng/mL±5.69 ng/mL,P<0.05,t=5.738).CD组25OHD缺乏的检出率高于NC组(86.7%vs 62.5%,P<0.05,X^2=6.649).血清25OHD水平与体质量指数(P<0.05,r=0.508),C反应蛋白(P<0.05,r=-0.713),血沉(P<0.05,r=-0.389),日照时间是否<30 min/d(P<0.05,r=0.362),疾病是否活动(P<0.05,r=0.384),是否使用类克(P<0.05,r=0.475)相关.日照时间<30min/d CD患者血清25OHD水平低于日照时间≥30 min/d者(10.33 ng/mL±5.75 ng/mL vs 14.47 ng/mL±5.91 ng/mL,P<0.05,t=2.371);无类克治疗史的CD患者血清25OHD水平低于有类克治疗史者(8.51 ng/mL±3.95ng/mL vs 14.19 ng/mL±6.21 ng/mL,P<0.05,t=3.302);活动期CD患者血清250HD水平低于缓解期患者(9.36 ng/mL±4.43 ng/mL vs14.05 ng/mL±6.44 ng/mL,P<0.05,t=2.693).结论:CD患者250HD水平明显低于健康人群,疾病活动度、日照时间、BMI以及类克治疗可以影响CD患者的250HD水平.

AIM： To detect serum 25OHD levels in patients with Crohn＇s disease, and to analyze the relationship between serum 25OHD level and clinical parameters of Crohn＇s disease.METHODS： Forty-five outpatients or inpatients with Crohn＇s disease （CD group） and 40 normal controls （NC group） were included in the study. Serum 25OHD levels were measured in all subjects by electrochemiluminescence. Correlation analysis was performed to identify the association between serum 25OHD levels and clinical indices of Crohn＇s disease. Afterwards, we analyzed the influence of related clinical indices on the level of serum 25OHD.RESULTS： Serum 25OHD level was significantly lower in the CD group than in the NC group （12.17 ng/mL ± 6.12 ng/mL vs 19.56 ng/mL ±5.69 ng/mL, P 〈 0.05, t = 5.738）. The detection rate of 25OHD deficiency was significantly higher in the CD group than that of the NC group （86.7% vs 62.5%, P 〈 0.05, 2 = 6.649）. Serum 25OHD level was correlated with BMI （P 〈 0.05, r = 0.508）, CRP （P 〈 0.05, r = -0.713）, ESR （P 〈 0.05, r = -0.389）, duration of exposure to sunshine 〈 30 min/d （P 〈 0.05, r = 0.362）, active disease （P 〈 0.05, r = 0.384） and use of remicade （P 〈 0.05, r = 0.475）. Serum 25OHD level was significantly lower in patients with Crohn＇s disease whose duration of exposure to sunshine was 〈 30 rain/d than in those with a duration of exposure to sunshine 〉 30 min/d （10.33 ng/mL ± 5.75 ng/mL vs 14.47 ng/mL ± 5.91 ng/mL, P 〈 0.05, t = 2.371）, in patients who did not use remicade than in those who used remicade （8.51 ng/mL ± 3.95 ng/mL vs 14.19 ng/mL ±6.21 ng/mL, P 〈 0.05, t = 3.302）, and in patients with active disease than in those with an inactive stage （9.36 ng/mL ± 4.43 ng/ mL vs 14.05 ng/mL ± 6.44 ng/mL, P 〈 0.05, t = 2.693）. CONCLUSION： Patients with Crohn＇s disease have significantly lower serum 25OHD level than healthy people. Disease activity, duration of exposure to sunshine and use of remicade can affect serum 25OHD levels in patients with Crohn＇s disease.