| Objective: To analyze the expression and clinical significance of25-hydroxyvitamin D（25（OH）D）and D-dimer（D-D）in peripheral blood of Rheumatoid arthritis（RA）patients,and to provide a theoretical basis for the treatment and prevention of RA.Methods: 1.In this study,137 RA patients were collected as the observation group and divided into 47 cases in high activity group,36 cases in moderate activity group,26 cases in low activity group and 28 cases in remission group according to disease activity score 28（DAS28）-ESR.At the same period,68 healthy subjects were selected as the control group to analyze the expression of 25（OH）D and D-D in different groups,the correlation with disease activities,as well as the correlation between them;2.According to the level of 25（OH）D in peripheral blood,these RA patients were divided into deficient group,insufficient group and sufficient group,and the general clinical data were analyzed between groups;3.According to different seasons,these RA patients were divided into spring group,summer group,autumn group and winter group and the peripheral blood 25（OH）D levels and the DAS28-ESR scores of patients in different seasons were compared and analyzed;4.The relationship between D-D level and clinical data were analyzed.Results: 1.The level of 25（OH）D in control group（35.31±3.01）ng/m L was significantly higher than that in high activity group（11.38±2.69）ng/m L,moderate activity group（16.15±3.41）ng/m L,low activity group（18.76±3.16）ng/m L and remission group（26.27±5.33）ng/m L（P<0.001）;The level of D-D in control group（0.534±0.144）mg/L was significantly lower than that in high activity group（4.716±0.781）mg/L,moderate activity group（3.792±1.008）mg/L,low activity group（1.645±0.368）mg/L and remission group（1.208±0.972）mg/L（P<0.001）;2.The level of 25（OH）D was significantly negative correlated with the level of D-D and DAS28score（all P<0.001）.There was significantly positive correlation between the level of D-D and DAS28-ESR score（P<0.001）.The level of 25（OH）D was negatively correlated with IL-6（P<0.001）,CRP（P=0.001）,anti-CCP（P=0.047）,swollen joint count（SJC）（P=0.018）,tender joint count（TJC）（P=0.002）,but not correlated with Hb,PLT,ESR and RF（all P>0.05）.The level of D-D was positively correlated with IL-6（P=0.003）,ESR（P=0.019）,CRP（P=0.007）,SJC（P=0.002）and TJC（P=0.007）,but not correlation with Hb,PLT,RF and anti-CCP（all P>0.05）;3.The levels of CRP（P=0.024）and IL-6（P=0.001）in the 25（OH）D sufficient group were lower than those in the insufficient group and the deficient group,while there were no statistical significance in levels of RF,anti-CCP,ESR,Hb and PLT（all P>0.05）.The incidence of joint malformation（P=0.018）and TJC（P=0.040）in the sufficient group was lower than that in the insufficient group and the deficient group,while there was no statistical significance compared with morning stiffness>1h,subcutaneous nodules,pericarditis,Raynaud’s phenomenon,pulmonary hypertension,pleural effusion,lung interstitial lesions and SJC（all P>0.05）.The score of DAS28-ESR in the sufficient group（1.53±0.87）was significantly lower than that in the insufficient group（2.58±1.27）and the deficient group（4.55±1.11）（P<0.001）;4.The average levels of 25（OH）D（18.49±7.19）ng/m L in spring group,（20.52±7.42）ng/m L in summer group were higher than those in autumn group（16.25±5.23）ng/m L and winter group（14.02±4.16）ng/m L（P<0.001）;The average DAS28-ESR score in spring group was（3.43±1.57）,and that in summer group was（3.13±1.66）lower than that in autumn group（4.22±1.25）and winter group（4.67±1.19）（P<0.001）;5.The different level of D-D was no statistical significance with gender,age,morning stiffness time>1h,joint malformation,subcutaneous nodules,Raynaud’s phenomenon,pulmonary hypertension,lung interstitial lesions and SJC（all P>0.05）.However,patients with high levels of D-D had more TJC（P=0.038）.Conclusion: 1.The level of 25（OH）D in peripheral blood of RA patients was lower than that of healthy people and was closely related to disease activity.RA patients with low levels of 25（OH）D had a higher incidence of joint malformations and more TJC;2.The level of 25（OH）D in peripheral blood of RA patients was higher in summer group and lower in winter group;The level of DAS28-ESR score was lower in summer group and higher in winter group;3.The level of D-D in peripheral blood of RA patients was higher than that of healthy people and was closely related to disease activity.The numbers of TJC were higher in D-D patients with elevated levels;The level of 25（OH）D in serum was negatively correlated with the level of D-D in plasma;4.The levels of 25（OH）D and D-D can be provided a good indication for assessing the disease activity of RA patients,and be provided a theoretical basis for the treatment and prevention of RA. |
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