类风湿关节炎患者血清25羟维生素D水平及相关因素分析

Analysis of serum 25-hydroxyvitamin D levels in patients with rheumatoid arthritis and its related factors

目的检测类风湿关节炎患者血清25羟维生素D水平并分析影响其水平的相关因素。方法收集亳州市人民医院2017年3～12月类风湿关节炎就诊患者及体检健康人群各82例,测定其血清25羟维生素D水平,并采集患者一般资料、体重指数、日晒时间、类风湿因子、抗环瓜氨酸多肽抗体、抗核抗体、血钙、疾病活动度(DAS28)、压痛关节数或肿胀关节数等临床资料,进行统计。结果 97.6%的类风湿关节炎患者存在血清25羟维生素D不足或缺乏,类风湿关节炎患者的血清25羟维生素D含量低于健康人群(P <0.01);病程不足2年的类风湿关节炎患者25羟维生素D水平高于病程2年以上者(P <0.05);男性类风湿关节炎患者25羟维生素D水平明显高于女性(P <0.05);类风湿关节炎患者25羟维生素D水平与女性(r=-0.291,P <0.01)、平均日晒时间(r=0.237,P <0.05)、病程(r=-0.322,P <0.01)、血钙水平(r=0.300,P <0.01)、压痛关节数(r=-0.348,P <0.01)、肿胀关节数(r=-0.238,P <0.05)和DAS28(r=-0.258,P <0.05)相关。结论类风湿关节炎患者普遍存在25羟维生素D不足或缺乏。女性、平均每日日晒时间小于30 min、病程长、低血钙、高DAS28、高压痛关节数、高肿胀关节数可能是其预测因素。

Objective To investigate serum 25-hydroxyvitamin D levels in patients with rheumatoid arthritis and its related factors.Methods Eighty-two cases of patients with rheumatoid arthritis and 82 cases of healthy controls were collected from Bozhou People′s Hospital from March to December 2017,the serum 25-hydroxyvitamin D level was measured,and the general characteristics,body mass index,sun exposure time,rheumatoid factor,cyclic citrullinated peptide antibodies,antinuclear antibodies,calcium,disease activity score(DAS28),tender joint count and swollen joint count were collected.Results The serum 25-hydroxyvitamin D level insufficiency and deficiency was detected in 97.6%of rheumatoid arthritis patients.The serum 25-hydroxyvitamin D concentration in rheumatoid arthritis patients were lower than that in healthy control(P<0.01).Patients with rheumatoid arthritis with a course of less than 2 years had a higher level of 25-hydroxyvitamin D than patients with a course of more than 2 years(P<0.05).Among patients with rheumatoid arthritis,25-hydroxyvitamin D levels in male were significantly higher than in female(P<0.05).In rheumatoid arthritis patients,serum 25-hydroxyvitamin D level was significantly associated with female(r=-0.291,P<0.01),average sun exposure time(r=0.237,P<0.05),course(r=-0.322,P<0.01),calcium level(r=0.300,P<0.01),tender joint count(r=-0.348,P<0.01),swollen joint count(r=-0.238,P<0.05)and DAS28(r=-0.258,P<0.05).Conclusion 25-hydroxyvitamin D insufficiency and deficiency is quite common in patients with rheumatoid arthritis.Female,average daily sun exposure time less than 30 minutes,longer course,hypocalcemia,higher DAS28,more tender joint count and swollen joint count might be the predictors.