血清维生素D水平与狼疮性肾炎患者狼疮活动度的相关性研究

发布时间：2019-06-30 20:02

【摘要】：目的:通过检测初发狼疮性肾炎(LN)患者及健康对照组中血清25-羟-维生素D(25-OH-D)水平,及分析LN患者血清25(OH)D水平与相关实验室指标及狼疮活动度的相关性,初步探讨维生素D在LN中的价值。方法:选择本院初次诊断为LN的患者40例,依据系统性红斑狼疮疾病活动指数(SLE disease activity index,SLEDAI)对LN患者进行评分,并将其分为轻度活动组(11例)、中度活动组(13例)、重度活动组(16例)。选择与LN患者性别、年龄、体重指数(Body Mass Index,BMI)、血清采集月份均相匹配的健康体检者40例。采用化学发光法(Chemiluminescence Immune Assay,CLIA)检测各组血清25(OH)D水平,比较各组间的差异,分析LN患者血清25(OH)D水平与相关实验室指标及狼疮活动度间的相关性。采用SPSS13.0统计软件进行分析。结果：1.LN患者血清25(OH)D水平[(14.71±6.90)ng/ml]较正常对照组血清25(OH)D水平[(25.30±2.82)ng/m1]明显降低,差异有统计学意义(p0.05)。2.LN患者血清25(OH)D水平与24小时尿蛋白呈负相关,r=-0.55,p0.05,且24小时尿蛋白≥3g患者的血清25(OH)D水平(11.32±2.61ng/ml)比24小时尿蛋白3g患者的血清25(OH)D水平(15.03±3.20ng/ml)低,p0.05;与血白蛋白呈正相关,r=0.86,p0.05,且血白蛋白≥35g患者的血清25(OH)D水平(15.86±6.21ng/ml)比血白蛋白35g患者的血清25(OH)D水平(13.64±7.56ng/ml)高,p0.05,以上均具有统计学意义。3.LN患者血清25(OH)D水平与抗ds-DNA抗体呈负相关,β=-0.25,p0.05;与补体3(C3)呈正相关,β=0.22,p0.05;与补体4(C4)呈正相关,β=0.27,p0.05,与SLEDAI呈负相关,β=-0.29,p0.05,且LN患者的血清25(OH)D水平随轻度(24.15±1.27ng/ml)、中度(19.88±2.63ng/ml)、重度(9.69±3.04ng/ml)的狼疮活动程度的加重越来越低,p0.05,以上均具有统计学意义。LN患者血清25(OH)D水平与血沉及C反应蛋白(CRP)无相关性,p0.05。结论:25(OH)D可能在LN的发病机制中起重要作用,动态监测LN患者血清25(OH)D水平,可能有助于监测狼疮活动、判断病情轻重、选择治疗方案,同时血清25(OH)D可能作为观察LN患者疗效的临床参考指标。
[Abstract]:Objective: to detect the level of serum 25-hydroxyvitamin D (25-OH-D) in patients with primary lupus nephritis (LN) and healthy control group, and to analyze the correlation between serum 25-(OH) D level and related laboratory indexes and lupus activity in patients with LN, and to explore the value of vitamin D in LN. Methods: 40 patients with LN diagnosed in our hospital were selected and graded according to systemic lupus erythematosus disease activity index (SLE disease activity index,SLEDAI). The patients were divided into mild active group (n = 11), moderate active group (n = 13) and severe active group (n = 16). 40 healthy subjects matched with sex, age, body mass index (Body Mass Index,BMI) and serum collection month of LN were selected. The serum 25 (OH) D level was measured by chemiluminescence (Chemiluminescence Immune Assay,CLIA, and the difference among the three groups was compared. the correlation between the serum 25 (OH) D level and the related laboratory indexes and lupus activity in LN patients was analyzed. SPSS13.0 statistical software was used for analysis. Results: the serum 25 (OH) D level of 1.LN patients [(14.71 卤6.90) ng/ml] was significantly lower than that of normal control group [(25.30 卤2.82) ng/m1], the difference was statistically significant (p0.05). The serum 25 (OH) D level of patients with 1.LN was negatively correlated with 24-hour urinary protein, r 鈮，

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