AIH患者外周血25-羟维生素D3水平及其与肝功能的相关性分析

The level of 25-dihydroxyvitamin D3 in peripheral blood and its correlation with liver function in patients with autoimmune hepatitis

目的:分析自身免疫性肝炎(AIH)患者外周血25-羟维生素D3[25-(OH)D3]水平及其与肝功能的相关性。方法:选取187例AIH患者和同期150名体检健康者作为研究对象,并分别设为观察组和对照组;观察组再依据炎症活动度评分分为活动期组(n=120)和缓解期组(n=67);比较两组对象及观察组不同炎症活动度患者的外周血25-(OH)D3、谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)、直接胆红素(DBIL)水平,分析外周血25-(OH)D3水平与ALT、AST、TBIL、DBIL水平的相关性及25-(OH)D3对AIH的诊断效能。结果:观察组患者外周血25-(OH)D3水平低于对照组(P<0.05),ALT、AST、TBIL及DBIL水平高于对照组(P<0.05)。活动期组外周血25-(OH)D3水平低于缓解期组(P<0.05),ALT、AST、TBIL及DBIL水平高于缓解期组(P<0.05)。相关分析显示,外周血25-(OH)D3与ALT、AST、TBIL、DBIL水平呈负相关性(P<0.05)。ROC曲线分析显示,外周血25-(OH)D诊断AIH的敏感度为91.70%、特异度为83.30%、AUC为0.917(95%CI:0.829~1.000)。结论:AIH患者外周血25-(OH)D3水平呈低表达,ALT、AST、TBIL及DBIL水平呈高表达,外周血25-(OH)D3水平的降低可能与肝功能下降有关。

Objective:To analyze the level of peripheral blood 25-hydroxyvitamin D3[25-(OH)D3]and its correlation with liver function in patients with autoimmune hepatitis(AIH).Methods:A total of 187 AIH patients were enrolled as observation group,150 healthy people were selected as the control group during the same period.The observation group was divided into active phase group(n=120)and remission phase group(n=67)according to the inflammatory activity score.The levels of peripheral blood 25-(OH)D3 and liver function indexes[alanine aminotransferase(ALT),aspartate transaminase(AST),total bilirubin(TBIL),direct bilirubin(DBIL)]were detected.The correlation between 25-(OH)D3 level and ALT,AST,TBIL,DBIL levels,and the efficacy of 25-(OH)D3 for AIH were analyzed.Results:The level of peripheral blood 25-(OH)D3 in observation group was lower than that in control group(P<0.05),while levels of ALT,AST,TBIL and DBIL were higher than those in control group(P<0.05).The level of peripheral blood 25-(OH)D3 in active phase group was lower than that in remission phase group(P<0.05),while levels of ALT,AST,TBIL and DBIL were higher than those in remission phase group(P<0.05).Correlation analysis showed that level of peripheral blood 25-(OH)D3 was negatively correlated with levels of ALT,AST,TBIL and DBIL(P<0.05).ROC curve analysis showed that the sensitivity,specificity and AUC of peripheral blood 25-(OH)D in diagnosing AIH were 91.70%,83.30%and 0.917(95%CI:0.829~1.000).Conclusion:The level of peripheral blood 25-(OH)D3 is low,while levels of ALT,AST,TBIL and DBIL are high in AIH patients.The decrease of peripheral blood 25-(OH)D3 may be related to the decline of liver function.