| 摘要: |
| 目的探讨血清25-羟-维生素D[25（OH）D]与类风湿关节炎（RA）疾病活动度的关系及补充活性维生素D对RA疾病活动度的影响。方法检测118例RA患者血清25（OH）D水平，将25（OH）D低下的89例RA患者按随机数字表法分为研究组45例和对照组44例，均进行标准治疗，其中研究组在此基础上口服阿法骨化醇胶丸（每次0.25滋g×2粒，1次/d），观察期为12个月。在入组前（基线）、3、6及12个月时均测定患者血清25（OH）D、血沉（ESR）、C反应蛋白（CRP）及进行28关节疾病活动度（DAS28）评估。分析血清25（OH）D与DAS28、ESR、CRP的相关性，比较两组25（OH）D水平、DAS28评分的差异。结果与基线比较，两组患者12个月时血清25（OH）D水平均上升、DAS28评分均下降（均P＜0.05）。研究组6、12个月时血清25（OH）D水平高于对照组，差异均有统计学意义（P＜0.05或0.01），但DAS28评分比较差异无统计学意义。在RA疾病本身基础状态下血清25（OH）D与DAS28评分呈负相关（r=-0.403，P＜0.05）。将各观察点的血清25（OH）D水平与DAS28评分进行总体相关分析，均呈负相关（r=-0.534、-0.691、-0.639，均P＜0.001）。结论RA患者中有75.42%（89/118）血清25（OH）D降低；血清25（OH）D与DAS28评分、ESR、CRP值呈负相关；补充活性维生素D对降低DAS28评分有一定的作用，但不显著。 |
| 关键词: 类风湿关节炎 疾病活动度 25 羟维生素 D |
| DOI：10.12056/j.issn.1006-2785.2017.39.15.2016-1301 |
| 分类号: |
| 基金项目:湖州市科技局课题（2013GYB09） |
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| Association of vitamin D with disease activity of rheumatoid arthritis |
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YANG Xiaobing, SUN Yinghui, JIANG Feng
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Huzhou Third Municipal Hospital
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| Abstract: |
| Objective To investigate the association between vitamin D and disease activity of rheumatoid arthritis(RA). Methods Eighty-nine RA patients with vitamin D deficiency were divided into trial group (n=45) and control group (n=44) randomly. Two groups received standardized treatment while the trial group received additional α-calcidol (0.5滋g q.d.) treatment for 12 months. Patients were evaluated by the Disease Activity Score (DAS28) at baseline and 3, 6 and12 months of treatment; blood 25-hydroxyvitamin D, ESR, CRP levels were also measured. Results Compared with baseline level, DAS28 scores were decreased and 25-hydroxyvitamin D levels were increased at 12 month of treatment in both groups (P ＜0.05). The 25-hydroxyvitamin D levels in trial group was significant higher than those in control group at 6 month and 12 month of treatment (P＜0.05, P＜0.01). The scores of DAS28 was not significantly different between two groups (P ＞0.05). The 25-hydroxyvitamin D
levels were negatively correlated with DAS28 at all time points (r=-0.403, -0.534, -0.691 and -0.639, P＜0.05 or P＜0.001). Conclusion The 25-hydroxyvitamin D level is negatively correlated with the disease activity of rheumatoid arthritis, but the effect of 25-hydroxyvitamin D administration is uncertain in improving disease activety of RA patients. |
| Key words: Rheumatoid arthritis Disease activity score (DAS28) 25-hydroxyvitamin D |
