【摘要】：目的:通過檢測初發(fā)狼瘡性腎炎(LN)患者及健康對照組中血清25-羥-維生素D(25-OH-D)水平,及分析LN患者血清25(OH)D水平與相關(guān)實驗室指標(biāo)及狼瘡活動度的相關(guān)性,初步探討維生素D在LN中的價值。方法:選擇本院初次診斷為LN的患者40例,依據(jù)系統(tǒng)性紅斑狼瘡疾病活動指數(shù)(SLE disease activity index,SLEDAI)對LN患者進(jìn)行評分,并將其分為輕度活動組(11例)、中度活動組(13例)、重度活動組(16例)。選擇與LN患者性別、年齡、體重指數(shù)(Body Mass Index,BMI)、血清采集月份均相匹配的健康體檢者40例。采用化學(xué)發(fā)光法(Chemiluminescence Immune Assay,CLIA)檢測各組血清25(OH)D水平,比較各組間的差異,分析LN患者血清25(OH)D水平與相關(guān)實驗室指標(biāo)及狼瘡活動度間的相關(guān)性。采用SPSS13.0統(tǒng)計軟件進(jìn)行分析。結(jié)果：1.LN患者血清25(OH)D水平[(14.71±6.90)ng/ml]較正常對照組血清25(OH)D水平[(25.30±2.82)ng/m1]明顯降低,差異有統(tǒng)計學(xué)意義(p0.05)。2.LN患者血清25(OH)D水平與24小時尿蛋白呈負(fù)相關(guān),r=-0.55,p0.05,且24小時尿蛋白≥3g患者的血清25(OH)D水平(11.32±2.61ng/ml)比24小時尿蛋白3g患者的血清25(OH)D水平(15.03±3.20ng/ml)低,p0.05;與血白蛋白呈正相關(guān),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,以上均具有統(tǒng)計學(xué)意義。3.LN患者血清25(OH)D水平與抗ds-DNA抗體呈負(fù)相關(guān),β=-0.25,p0.05;與補體3(C3)呈正相關(guān),β=0.22,p0.05;與補體4(C4)呈正相關(guān),β=0.27,p0.05,與SLEDAI呈負(fù)相關(guān),β=-0.29,p0.05,且LN患者的血清25(OH)D水平隨輕度(24.15±1.27ng/ml)、中度(19.88±2.63ng/ml)、重度(9.69±3.04ng/ml)的狼瘡活動程度的加重越來越低,p0.05,以上均具有統(tǒng)計學(xué)意義。LN患者血清25(OH)D水平與血沉及C反應(yīng)蛋白(CRP)無相關(guān)性,p0.05。結(jié)論:25(OH)D可能在LN的發(fā)病機(jī)制中起重要作用,動態(tài)監(jiān)測LN患者血清25(OH)D水平,可能有助于監(jiān)測狼瘡活動、判斷病情輕重、選擇治療方案,同時血清25(OH)D可能作為觀察LN患者療效的臨床參考指標(biāo)。
[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 鹵6.90) ng/ml] was significantly lower than that of normal control group [(25.30 鹵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，

本文編號：2508211