血清25-羟基维生素D水平与类风湿关节炎合并干燥综合征病人病情的相关性及其意义

Correlation between serum 25-hydroxyvitamin D level and the disease of patients with rheumatoid arthritis complicated with Sjogren′s syndrome and its significance

目的:了解不同25-羟基维生素D[25-(OH)D3]水平与类风湿关节炎(RA)合并干燥综合征(SS)病人病情活动度及炎症因子等相关实验室指标的关系,探讨其临床意义。方法:选择90例RA合并SS病人为研究对象,采用化学发光法检测其血清中25-(OH)D3水平,按照25-(OH)D3水平分为缺乏组38例,不足组33例,正常组19例。同时,收集病人临床指标如关节疼痛与肿胀数目以及相关实验室指标;评估病人疾病活动度(DAS28、SDAI等)。分析各组间有关因素的差异及其相关性。结果:25-(OH)D3缺乏组、不足组、正常组病人DAS28、SDAI差异均有统计学意义(P<0.05和P<0.01),且25-(OH)D3水平显著减低组,DAS28、SDAI显著增高(P<0.05和P<0.01)。Pearson相关分析发现3组ESR、CRP与25-(OH)D3水平呈负相关关系(P<0.05)。结论:25-(OH)D3水平减低与RA合并SS病人ESR、CRP水平异常升高有一定的相关性,对病人RA病情的活动有一定影响;定期监测RA合并SS病人血清25-(OH)D3水平,及时纠正25-(OH)D3缺乏可能有助于促进其病情缓解。

Objective:To investigate the relationship between different levels of 25-hydroxyvitamin D[25-(OH)D3]and disease activity,inflammatory factors and other related laboratory indexes in patients with rheumatoid arthritis(RA)complicated with Sjogren′s syndrome(SS),and to explore its clinical significance.Methods:Ninety patients with RA and SS were selected as the study subjects.The 25-(OH)D3 levels in serum were detected by chemiluminescence method and divided into three groups according to the 25-(OH)D3 levels:38 patients in the deficient group,33 patients in the insufficient group and 19 patients in the normal group.At the same time,clinical indicators such as the number of joint pain and swelling and related laboratory indicators were collected.Disease activity,such as DAS28 and SDAI,was evaluated.The differences and correlation of related factors among each group were analyzed.Results:The differences in DAS28 and SDAI among patients in 25-(OH)D3 deficiency,insufficiency,and normal groups were statistically significant(P<0.05 and P<0.01),and the group with significantly reduced levels of 25-(OH)D3 had significantly higher DAS28 and SDAI(P<0.05 and P<0.01).Pearson correlation analysis found a negative correlation between ESR,CRP and 25-(OH)D3 levels in the three groups(P<0.05).Conclusions:The decreased level of 25-(OH)D3 is correlated with the abnormal increase of ESR and CRP levels in RA patients with SS,and has a certain effect on the activity of RA disease.Regular monitoring of serum 25-(OH)D3 levels in RA patients with SS and timely correction of 25-(OH)D3 deficiency may help promote remission.