文章摘要
杨孝兵,孙颖慧,蒋峰.维生素D与类风湿关节炎疾病活动度的关系分析[J].,2017,39(15):1284-1286.
维生素D与类风湿关节炎疾病活动度的关系分析
Association of vitamin D with disease activity of rheumatoid arthritis
  
DOI:10.12056/j.issn.1006-2785.2017.39.15.2016-1301
中文关键词: 类风湿关节炎 疾病活动度 25 羟维生素 D
英文关键词: Rheumatoid arthritis Disease activity score (DAS28) 25-hydroxyvitamin D
基金项目:湖州市科技局课题(2013GYB09)
作者单位
杨孝兵 湖州市第三人民医院风湿免疫科 
孙颖慧  
蒋峰  
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中文摘要:
      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。
英文摘要:
      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.
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