结缔组织病肺间质病变患者25羟基维生素D水平变化及临床意义

摘要

Objective To investigate the connective tissue disease associated interstitial lung disease (CTD-ILD ) serum 25-hydroxyvitamin D [25 (OH)D]levels and its clinical significance.Methods Forty cases of CTD-ILD and 30 patients with healthy controls were selected.The serum 25 (OH)D levels were measured by ELISA.T-test and one-way ANOVA were used for date analysis,and Pearson's test was adopted for correlation analysis.Results 25 (OH)D levels of CTD-ILD group were significantly lower than those of the normal con-trol group (t=-6.999,P<0.05);25 (OH)D levels in patients was negatively correlated with CTD-ILD body mass index (BMI)and e-rythrocyte sedimentation rate (ESR)(r=-0.374,-0.372,P<0.05 ),and was positively correlated with the patient percentage of predic-ted forced vital capacity (FVC%)(r=0.352,P<0.05);FVC%of PM/DM-ILD and SSc-ILD group was lower than that of other types of CTD-ILD,and the difference was statistically significant (t=2.055,P<0.05 ).According to the level of lung function,the patients were di-vided into normal group,mild lung injury group,moderate and severe lung injury group,and 25 (OH)D levels of four groups were followed by a downward trend and mutual differences were statistically significant (P<0.05).Further comparison among groups showed 25 (OH)D lev-els of normal group and mild group were significantly higher than those of moderate and severe lung injury group (P<0.05).Conclusion Serum 25 (OH)D levels of CTD-ILD group were significantly low,which is correlated with the decrease in lung function and plays a role in the pathogenesis of CTD-ILD.%目的：探讨结缔组织病合并肺间质病变（CTD-ILD）患者血清25羟基维生素D[25（OH）D]的水平变化及临床意义。方法收集40例CTD-ILD患者为CTD-ILD组，健康对照组30例，采用酶联免疫吸附试验（ELISA）法测定CTD-ILD患者的血清25（OH）D浓度，评价25（OH）D与临床指标的相关性。结果 CTD-ILD组25（OH）D平均水平明显低于正常对照组，差异有统计学意义（t＝-6．999，P＜0．05）。25（OH）D水平与CTD-ILD患者体质量指数（BMI）、血沉（ESR）呈负相关（r＝-0．374，-0．372， P＜0．05），与患者用力肺活量占预计值百分比（FVC％）呈正相关（r＝0．352，P＜0．05）。多发性肌炎/皮肌炎（PM/DM）-ILD与系统性硬皮病（SSc）-ILD组的FVC％水平低于其他类型CTD-ILD的FVC％水平，差异有统计学意义（t＝2．055，P＜0．05）。根据肺功能水平高低，分为肺功能正常组、轻度肺功能损伤组、中度肺功能损伤组及重度肺功能损伤组，4组间的25（OH）D水平呈依次下降趋势，且相互间差异有统计学意义（P＜0．05），正常组及轻度损伤组25（OH）D水平显著高于中度及重度肺功能损伤组，差异有统计学意义（P＜0．05）。结论 CTD-ILD组患者血清25（OH）D水平显著低下，且与肺功能的减退有关，在CTD-ILD的发病机制中可能发挥作用。