不同证型类风湿关节炎患者血清Ca2+水平相关性研究

Correlational research of serum calcium levels in RA patients with different traditional Chinese medicine syndromes

关键词:  类风湿关节炎  血清Ca²⁺水平  中医证型  疾病活动度  病程

Key words:  rheumatoid arthritis  serum calcium level  TCM syndrome type  disease activity  disease course

摘要:

[目的] 探究类风湿关节炎(RA)患者血清Ca²⁺水平与疾病活动的相关性及在不同中医证型中分布规律。[方法] 实验为1项回顾性研究,纳入2020年10月至2022年10月本院门诊及住院的RA患者160例为研究组,并选取在本院体检中心行常规体检的健康人群160例作为健康对照组(HC组),比较两组血清Ca²⁺水平差异。研究组中根据中医辨证分型为痰瘀痹阻证组、寒湿痹阻证组、湿热痹阻证组、肝肾亏虚证组4组,比较各证型组血清Ca²⁺水平差异。以Spearman相关性分析研究RA组血清Ca²⁺水平与血沉(ESR)、超敏C反应蛋白(hs-CRP)、类风湿因子(RF)、抗环瓜氨酸肽抗体(抗CCP抗体)水平、抗链球菌溶血素(ASO)及病程的关系,以Pearson相关性分析探究血清Ca²⁺水平与病情评价表(DAS28)的关系。[结果] RA组血清Ca²⁺水平低于HC组(P＜0.01)。在RA4个证型组中,痰瘀痹阻证组及寒湿痹阻证组血清Ca²⁺水平高于湿热痹阻证组和肝肾亏虚证组(P＜0.01)。RA患者血清Ca²⁺水平与DAS28呈负相关(r_s=-0.398,P＜0.01),与ESR呈负相关(r_s=-0.289,P＜0.01),与hs-CRP呈负相关(r_s=-0.351,P＜0.01),与病程呈负相关(r_s=-0.423,P＜0.01),与RF、抗CCP抗体、ASO无明显相关性。[结论] RA患者血清Ca²⁺浓度较健康人群显著降低,与疾病活动度及病程呈负相关。RA血清Ca²⁺水平在RA中医证型中的分布是有规律可循的,可为临床工作辨证分型提供客观参考价值。

Abstract:

[Objective] To explore the correlation between serum calcium level and disease activity in patients with rheumatoid arthritis (RA) and its distribution in different traditional Chinese medicine (TCM) syndromes.[Methods] A total of 160 outpatients and inpatients with RA in our hospital from October 2020 to October 2022 were enrolled as the study group,and 160 healthy people who underwent routine physical examination in the physical examination center of our hospital were selected as the healthy control group (HC group),and the differences in serum calcium levels between the two groups were compared. According to TCM syndrome differentiation,the study group was divided into four groups:phlegm and stasis syndrome group,cold-dampness obstruction syndrome group,damp-heat obstruction syndrome group,liver and kidney deficiency syndrome group. We compared the distribution of each serum calcium level among different groups of RA patients. Spearman correlation analysis was used to study the relationship between serum calcium level and erythrocyte sedimentation rate (ESR),hypersensitive C-reactive protein (hs-CRP),rheumatoid factor (RF),anti-cyclic citrullinated peptide (CCP) antibody level,antistreptolysin O (ASO) and the course of disease in RA patients. And pearson correlation analysis was used to explore the relationship between serum calcium level and Disease Activity Score 28 (DAS28).[Results] The serum calcium level in RA group was lower than that in HC group (P＜0.01). Among the four groups,the serum calcium level in the phlegm-stasis syndrome group and the cold-dampness obstruction syndrome group were significantly higher than that in the damp-heat obstruction syndrome group and the liver and kidney deficiency syndrome group (P＜0.01). The serum calcium level was negatively correlated with DAS28 (r_s=-0.398,P＜0.01),and negatively correlated with ESR (r_s=-0.289,P＜0.01). It was negatively correlated with hs-CRP (r_s=-0.351,P＜0.01),and negatively correlated with the course of disease (r_s=-0.423,P＜0.01),but had no significant correlation with RF,anti-CCP antibody and ASO.[Conclusion] Serum calcium level in RA patients is significantly lower than that in healthy people,which was negatively correlated with disease activity and disease course. The distribution of serum calcium level in TCM syndrome types of RA is regular,which provides objective reference value for TCM syndrome differentiation.