血清维生素D水平与慢性肝病相关性的临床研究

The clinical study on the correlation between the serum level of vitamin D and chronic liver disease

目的检测慢性肝病患者血清25-羟基维生素D(25(OH)D)水平并探讨其与肝功能分级的相关性。方法收集失代偿期肝硬化患者100例、慢性乙型病毒性肝炎(CHB)患者100例作为试验组,健康人100例作为对照组。检测各组患者血清25(OH)D水平。探讨25(OH)D水平在肝硬化组、CHB组、健康对照组之间的差异;分析肝硬化组患者血清25(OH)D水平与肝脏储备功能量化评估分级标准(Child-Pugh)分级和终末期肝病模型(MELD)评分之间的相关性。结果肝硬化组中25(OH)D水平缺乏或不足者共占73%;肝硬化组中25(OH)D水平缺乏的比例(38%)多于肝炎组(1%)及健康对照组(15%)(P均<0.05)。肝硬化组中,25(OH)D水平与Child-Pugh分级呈负相关(rs2=-0.559,P<0.001);25(OH)D水平与MELD评分呈负相关(r2=-0.551,P<0.001)。结论慢性肝病患者血清25(OH)D水平普遍较低,失代偿期肝硬化患者尤甚;慢性肝病患者血清25(OH)D水平与肝功能分级具有相关性,肝功能分级越差,血清25(OH)D水平越低。

Objective To detect the serum level of 25-hydroxy vitamin D(25(OH)D)in patients with chronic liver disease and discuss the correlation with liver function classification.Methods The Serum level of 25(OH)D was quantified in 100 decompensated liver cirrhosis patients;100 chronic hepatitis B patients and 100 healthy controls from physical examination center.The serum level of 25(OH)D in the present study was measured by batched electrochemiluminescence.The difference of the serum level of 25(OH)D among cirrhosis group,chronic hepatitis B group and healthy control group was explored.Meanwhile,the correlation among the level of 25(OH)D with Child-Pugh grade and the model for end-stage liver disease(MELD)score in cirrhotic patients was analyzed.Results In the cirrhosis group,the proportion of 25(OH)D deficiency accounted for 73%;the proportion of 25(OH)D deficiency in the cirrhosis group(38%)was more than that in the hepatitis group(1%)and the healthy control group(15%)(P all<0.05).In the cirrhosis group,25(OH)D levels were negatively correlated with Child-Pugh grade(r s 2=-0.559,P<0.001);25(OH)D levels were negative with MELD scores(r 2=-0.551,P<0.001).Conclusion 25(OH)D deficiency is highly prevalent in patients with chronic liver disease and is lower in patients with decompensated cirrhosis.The serum level of 25-hydroxy vitamin D in patients with chronic liver disease is correlated with liver function.The lower the grade of liver function,the lower the level of 25(OH)D.