摘要
目的：探讨慢性肝病患者血清25－羟维生素 D[25（OH）D]水平及其临床意义。方法收集2012年6月－2013年9月吉林大学第一医院肝胆胰内科153例慢性肝病住院患者的血清作为试验组，应用液相色谱串联质谱检测技术检测患者的25（OH）D水平，以同院体检中心300例健康人作对照组。试验组分为非肝硬化组、肝硬化组（Child －Pugh A、B、C 级）及原发性胆汁性肝硬化（PBC）组，分析比较各组间的差异，计量资料采用 t 检验和方差分析，计数资料采用χ2检验，各变量间相关性采用 Pearson 直线相关分析。结果153例慢性肝病患者正常（≥30 ng／ml）、不足（20～30 ng／ml）、缺乏（10～20 ng／ml）及严重缺乏（＜10 ng／ml）的比例分别为20．3％、22．9％、35．9％、20．9％。肝硬化组25（OH）D 缺乏及严重缺乏的比例（41．7％、25．0％）明显多于非肝硬化组（27．5％、12．5％）及 PBC 组（23．5％、17．6％），差异均有统计学意义（χ2＝6．261～18．474，P ＝0．001～0．012）。肝硬化组25（OH）D 水平为（18．58±12．48）ng／ml，低于非肝硬化组（23．78±11．81）ng／ml 及健康对照组（25．69±12．39）ng／ml，差异均有统计学意义（P值分别为0．029、0．001）。肝硬化组以 Child －Pugh 分级分组，C 级25（OH）D 水平明显低于 A 级，差异有统计学意义（P ＝0．009）。结论慢性肝病患者血清25（OH）D 水平普遍降低，其中肝硬化患者降低明显重于非肝硬化患者，尤其以 Child －Pugh 分级 C 级降低最为严重。
Objective To investigate the levels and clinical significance of serum 25 -hydroxy vitamin D[25 （OH）D]in patients with chronic liver disease.Methods A total of 153 hospitalized patients with chronic liver disease in the First Affiliated Hospital of Jilin Univer-sity from June 2012 to September 2013 were enrolled in the study group.The levels of serum 25（OH）D were measured by liquid chromatog-raphy tandem mass spectrometry.The serum samples from 300 healthy volunteers who underwent physical examination in our hospital were used as controls.The study group was divided into three subgroups：non -cirrhosis,liver cirrhosis [Child -Pugh （CP）grades A,B,and C],and primary biliary cirrhosis.Comparison of continuous data between groups was made by t test and analysis of variance,and compari-son of categorical data was made by chi -square test.Correlation between different variables was investigated by Pearson linear regression a-nalysis.Results Of the 153 patients with chronic liver disease,the percentages of those who had vitamin D adequacy （≥30 ng/ml）,in-sufficiency （20 -30 ng/ml）,deficiency （10 -20 ng/ml）,and severe deficiency （〈10 ng/ml）were 20.3%,22.9%,35.9%,and 20.9%,respectively.The percentages of patients with vitamin D deficiency and severe deficiency were significantly higher in the cirrhosis subgroup than in the non -cirrhosis and primary biliary cirrhosis subgroups （41.7%,25.0% vs 27.5%,12.5% and 23.5%,17.6%,re-spectively;χ2 =6.261 -18.474,P =0.001 -0.012）.The serum 25（OH）D levels in patients with cirrhosis were significantly lower com-pared with those in patients without cirrhosis and in controls （18.58 ±12.48 vs 23.78 ±11.81 and 25.69 ±12.39 ng/ml,P =0.029 and 0.001）.CP class C cirrhotic patients had significantly lower serum levels of 25（OH）D compared with CP class A patients （P =0.009）. Conclusion Serum 25（OH）D deficiency is common in patients with chronic liver disease.25（OH）D levels in cirrhotic patients,especial-ly in CP class C patients,are markedly lower than those in non -cirrhotic patients.
出处
《临床肝胆病杂志》
CAS
2015年第5期754-757,共4页
Journal of Clinical Hepatology
关键词
肝疾病
维生素
D
缺乏
liver diseases
vitamin D deficiency
