类风湿关节炎患者的骨密度与25-羟维生素D3的相关性研究

发布时间：2018-01-11 00:07

  本文关键词：类风湿关节炎患者的骨密度与25-羟维生素D3的相关性研究　出处：《川北医学院》2016年硕士论文　论文类型：学位论文

  更多相关文章： 类风湿关节炎 25-羟维生素D3 骨密度

【摘要】：目的:本研究通过对RA患者的外周血的25(OH)D3水平及左手前臂中下1/3处骨密度(BMD)的测量,根据不同组间RA患者血浆25(OH)D3浓度变化和骨密度差异,探讨类风湿关节炎的发病机制及二者与类风湿关节炎严重程度的相关性,为RA疾病的诊断治疗提供依据。方法:收集川北医学院附属风湿免疫科2014年7月至2015年8月门诊及住院部的82例类风湿关节炎患者及52例健康者外周血,根据RA患者手指骨X平片表现分期不同,将患者分为4组,其中I组22例、Ⅱ组29例、Ⅲ组19例、Ⅳ组12例。将收集的外周血标本通过ELISA方法检测血清25(OH)D3水平,同时应用EXA-3000双能X射线骨密度测量仪测量类风湿关节炎患者和健康者的左侧前臂中下1/3处的骨密度,对比分析不同严重程度分组RA患者血清25(OH)D3水平和骨密度的变化及意义,探讨RA患者血清25(OH)D3水平和骨密度与RA的关系。结果:1.RA组的25(OH)D3浓度为(23.51±3.02)ng/ml明显低于对照组的25(OH)D3浓度(26.25±3.74)ng/ml,差异具有统计学意义(P0.05);而RA组的骨密度为(0.329±0.072)g/cm2,明显低于对照组的骨密度(0.465±0.065)g/cm2,差异具有统计学意义(P0.05)。2.RA患者I组、Ⅱ组、Ⅲ组、Ⅳ组4组及健康对照组的25(OH)D3浓度分别为(26.06±4.05)ng/ml、(20.45±3.38)ng/ml、(17.37±2.88)ng/ml、(14.01±2.45)ng/ml、(26.25±3.74)ng/ml。I组25(OH)D3浓度与健康对照组比较,差异无统计学意义(p0.05);组25(OH)D3浓度明显低于健康对照组,差异有统计学意义(p0.05);ra患者i、Ⅱ、Ⅲ、Ⅳ各组之间两两比较,iv组25(oh)d3浓度明显低于Ⅲ组,差异有统计学意义(p0.05);Ⅲ组25(oh)d3浓度明显低于i、Ⅱ组,差异有统计学意义(p0.05);Ⅱ组25(oh)d3浓度明显低于i组,差异有统计学意义(p0.05)3.ra患者i组、Ⅱ组、Ⅲ组、iv组4组及健康对照组的骨密度(bmd)分别为(0.457±0.061)g/cm2、(0.318±0.035)g/cm2、(0.297±0.049)g/cm2、(0.235±0.024)g/cm2、(0.465±0.065)g/cm2。i组骨密度与健康对照组比较,差异无统计学意义(p0.05);Ⅱ组、Ⅲ组、Ⅳ组骨密度明显低于健康对照组,差异有统计学意义(p0.05);ra患者i、Ⅱ、Ⅲ、iv各组之间两两比较,iv组骨密度明显低于Ⅲ组,差异有统计学意义(p0.05);Ⅲ组骨密度明显低于i、Ⅱ组,差异有统计学意义(p0.05);Ⅱ组骨密度明显低于i组,差异有统计学意义(p0.05)。4.ra各组患者外周血25(oh)d3浓度随着疾病的严重程度增加而降低,呈负相关,相关系数r=-0.72,相关性有统计学意义(p0.05);ra各组患者骨密度随着疾病的严重程度增加而降低,呈负相关,相关系数r=-0.63,相关性有统计学意义(p0.05);ra各组患者外周血25(oh)d3浓度与骨密度呈正相关,相关系数r=0.67,相关性有统计学意义(p0.05)。结论:1.ra患者外周血25(oh)d3浓度与骨密度较对照组明显降低,推测25(oh)d3可能参与了ra的发生发展。2.随着ra病情加重,患者血清25(oh)d3浓度与骨密度逐渐降低,且25(oh)d3浓度与骨密度呈正相关,25(oh)d3浓度与骨密度可能成为RA病情严重程度的评估指标。3.推测RA患者服用维生素D可抑制自身免疫反应,缓解RA急性期症状,延缓疾病进展。
[Abstract]:Objective: To study the peripheral blood of patients with RA 25 (OH) D3 levels and the left forearm and lower 1/3 of bone mineral density (BMD) measurements, according to the different groups of patients with RA 25 (OH) D3 concentration and bone density differences, to explore the pathogenesis of rheumatoid arthritis and two with rheumatoid arthritis severity, provide the basis for the diagnosis and treatment of RA disease. Methods: 82 cases of patients with rheumatoid arthritis were collected affiliated to North Sichuan Medical College Department of Rheumatology in July 2014 to August 2015 in outpatient and inpatient and 52 cases of normal peripheral blood of RA patients, according to the finger bone X flat performance in different stages, the patients were divided into 4 group, including 22 cases of I group, 29 cases of group II, 19 cases of group III, IV group of 12 cases. The collected peripheral blood samples by ELISA method for the detection of the serum level of D3 25 (OH), at the same time the application of EXA-3000 dual energy X ray absorptiometry measurement of rheumatoid arthritis patients and health 搴疯，

本文编号：1407320