类风湿关节炎患者骨密度改变与血清25-羟维生素D_3水平的关系分析

Relationship Between Changes of Bone Mineral Density and Serum Levels of 25-hydroxyvitamin D_3 in Patients with Rheumatoid Arthritis

目的分析类风湿关节炎(RA)患者骨密度改变与血清25-羟维生素D_3[(25-(OH)D_3)]水平的关系。方法选取2014年5月至2017年5月我院收治的RA患者96例为研究对象,另选取50例同期入院体检的健康志愿者为对照组,对比不同严重程度RA患者与对照组血清25-(OH)D_3水平及骨密度(BMD)、骨密度T值,分析25-(OH)D_3不同缺乏程度患者BMD、骨密度T值,分析RA患者25-(OH)D_3水平与BMD及骨密度T值关系。结果 RA组血清25-(OH)D_3水平、BMD、骨密度T值低于对照组(P<0.05);RA分期Ⅳ期患者血清25-(OH)D_3水平、BMD、骨密度T值低于Ⅰ、Ⅱ、Ⅲ期(P<0.05);随25-(OH)D_3缺乏程度加重,RA患者BMD、骨密度T值下降(P<0.05);相关分析显示RA患者血清25-(OH)D_3水平与BMD、骨密度T值呈正相关(r=0.453、0.324,P均<0.05)。结论 RA患者骨密度改变与其血25-(OH)D_3水平存在密切关系,随RA病情加重,患者血清25-(OH)D_3水平及BMD下降,且25-(OH)D_3水平缺乏程度加重,骨密度降低越明显,因此在RA治疗中可补充维生素D而改善预后。

Objective To analyze the relationship between changes of bone mineral density and serum levels of 25- hydroxyvitamin D3 [ （ 25- （OH） D3 ） in patients with rheumatoid arthritis （RA）. Methods 96 RA patients treated in our hospital from May 2014 to May 2017 were selected as the study subjects,and other 50 healthy volunteers hospitalized at the same period for physical examination were selected as the control group. The different severity of RA patients and serum 25- （ OH ） D3 levels and bone mineral density （ BMD ）, bone mineral density T value were compared, and the BMD and the bone mineral density T value in the different lack of 25-（OH） D3 were analyzed, and the relationship of 25-（OH） D3 level and BMD and bone mineral density T value was analyzed between the RA patients. Results The levels of serum 25- （OH） D3, BMD and bone mineral density T value were in the RA group, which were lower than those in the control group （ P 〈 0.05 ）. The levels of serum 25- （OH） D3, BMD and bone mineral density T value in patients with RA stage IV were lower than those in stage I, II and III （ P 〈 0.05 ）. With the increase of 25- （OH） D3, the BMD and bone mineral density T value of RA patients were decreased（ P 〈 0.05 ）. Correlation analysis showed that the level of serum 25- （OH） D3 in RA patients was positively correlated with BMD and bone mineral density T value（ r =0.453,0. 324,all P 〈0.05）. Conclusion The changes of bone mineral density in RA patients are closely related to the 25- （OH） D3 levels. And with the severity of RA, the levels of 25- （OH） D3 and BMD are decreased, and the 25-（ OH ）D3 lack is increased and the bone mineral density is decreased obviously Therefore the treatment of RA can be supplemented with vitamin D to improve the prognosis.