慢性荨麻疹患者血清25羟基维生素D水平检测及意义

Detection of serum levels of 25-hydroxy vitamin D in patients with chronic urticaria and its clinical significance

目的 检测慢性荨麻疹患者血清25羟基维生素D水平，探讨25羟基维生素D（25HVD）在慢性荨麻疹（CU）发病中的作用。方法 收集50例CU患者及40例健康对照血清，同时应用CU症状评分标准（UAS）对疾病进行评分；用 ELISA测定血清25HVD、干扰素γ（IFN-γ）、白细胞介素4（IL-4）、免疫球蛋白E（IgE）水平。所得数据采用t检验、秩和检验、直线相关回归分析进行统计学分析。结果 CU组血清25HVD水平［（15.20 ± 7.72） μg/L］明显低于对照组［（21.54 ± 8.31） μg/L，t = 3.75，P 〈 0.05］，且两组25HVD水平分布比较，差异有统计学意义（H = 17.9，P 〈 0.05）。UAS评分重度组25HVD水平［（15.57 ± 7.38） μg/L］与轻度组［（14.86 ± 6.28） μg/L］差异无统计学意义（t = 0.37，P 〉 0.05）。CU组血清IFN-γ水平明显低于对照组（t = 15.34， P 〈 0.05），但血清IL-4和IgE水平明显高于对照组（t值分别为6.54， 4.88，均P 〈 0.05）。CU组血清25HVD水平与IFN-γ水平呈正相关（r = 0.738，P 〈 0.05），与IL-4水平呈负相关（r = -0.689，P 〈 0.05），与IgE水平无相关性（r = -0.271，P 〉 0.05）。结论 CU患者血清25HVD水平明显降低，可能通过介导Th1细胞/Th2细胞失衡参与CU的发生。

Objective To measure serum levels of 25-hydroxyvitamin D （25HVD） in patients with chronic urticaria （CU）, and to explore its role in the occurrence of CU. Methods Peripheral blood samples were obtained from 50 patients with CU and 40 healthy controls. The urticaria activity score （UAS） was used to assess the severity of CU and to group the patients with CU. Enzyme-linked immunosorbent assay （ELISA） was performed to measure the serum levels of 25HVD, interferon-γ （IFN-γ）, interleukin-4 （IL-4） and immunoglobulin E （IgE）. Statistical analysis was carried out by t test, rank sum test and linear correlation analysis. Results The serum level of 25HVD was significantly lower in the patients with CU than in the healthy controls （15.20 ± 7.72 vs. 21.54 ± 8.31 μg/L, t = 3.75, P 〈 0.05）. Moreover, there was a significant difference in the distribution of serum 25HVD levels between the patients and healthy controls （H = 17.9, P 〈 0.05）. However, no significant difference was observed in the serum level of 25HVD between severe and mild CU groups （15.57 ± 7.38 vs. 14.86 ± 6.28 μg/L, t = 0.37, P 〉 0.05）. Compared with the control group, the patient group showed significantly decreased serum levels of IFN-γ （t = 15.34, P 〈 0.05）, but increased serum levels of IL-4 and IgE （t = 6.54, 4.88, respectively, both P 〈 0.05）. Among the patients with CU, the serum level of 25HVD was positively correlated with that of IFN-γ （r = 0.738, P 〈 0.05）, but negatively correlated with that of IL-4 （r = -0.689, P 〈 0.05）, and uncorrelated with that of IgE （r = -0.271, P 〉 0.05）. Conclusion The serum level of 25HVD evidently decreased in patients with CU, and it may participate in the occurrence of CU by mediating the Th1/Th2 imbalance.