The Research Of 1,25–Dihydroxy Vitamin D3 In The Treatment Of Rheumatoid Arthritis

Background:Rheumatoid Arthritis?RA?is a chronic and systemic autoimmune disease characterized by erosion and symmetric polyarthritis.Epidemiological data show that RA can occur at different age levels,most of which are between the ages of 35 and50,and far more women than men.RA can be divided into the expression of synovial inflammatory and joint structural damage in the joint,the former is reversible after treatment,and the latter is difficult to reverse once it appears.Joint dysfunction caused by bone damage and bone loss is a major risk factor^[1],but its pathogenesis is not clear.1,25–dihydroxy vitamin D3 is a steroid hormone,its role in the body is usually by ultraviolet synthesis in the skin,it involved in bone metabolism of calcium and phosphorus,by adjusting the gastrointestinal absorption of calcium,the calcium homeostasis in regulation,the role of 1,25–dihydroxy vitamin D3 is still be investigated.1,25–dihydroxy vitamin D3 has been found to have immunomodulatory function.Recent studies have found that 1,25–dihydroxy vitamin D3 plays an important role in maintaining the balance of the RA immune system by regulating the immune system of Dendritic cells,T and B lymphocytes.Therefore,1,25–dihydroxy vitamin D3 May also play a role in the development of RA.However,the mechanism and pathway of 1,25–dihydroxy vitamin D3 in RA is not clear,and 1,25–dihydroxy vitamin D3 is used to further explore its role in RA therapy and its possible role.Serum 25-hydroxyl vitamin D[25?OH?D]is the main metabolic intermediate product of1,25–dihydroxy vitamin D3 in the body,and it is stable in the blood in the body and has a long half-life,which can be directly reversed in the body.This topic by monitoring the RA patients before and after treatment for 12 weeks,24 weeks in serum 25?OH?D level,analysis and disease activity score DAS28 and related inflammatory indexes such as Erythrocyte Sedimentation Rate,C–reactive protein,and explore the 1,25–dihydroxy vitamin D3 in RA treatment is effective.Objective:Explore the role of 1,25–dihydroxy vitamin D3 in the treatment of rheumatoid arthritis.Methods:Collect 2015.10-2018.02 in the first affiliated hospital of henan university of science and technology of inpatient and outpatient li rheumatism lead of the first diagnosis of 72 patients with rheumatoid arthritis?RA?,will be randomly divided into experimental group and control group,control group treatment methods:methotrexate piece?5mg?batch number:MAO auspicious H22022674 tonghua pharmaceutical factory production,each time10 mg,1 times a week;Glucoside tripterygium wilfordii more batch number:Z31020415shanghai fudan fuhua pharmaceutical factory production according to the weight per 1 kg 1-1.5 mg per day.Three times after meals.The experimental group is in the control group on the basis of conventional treatment combined with 1,25?OH?₂D₃ 0.25ugd^-1,respectively,before treatment,treatment for12 weeks,24 weeks group and control group of serum 3 ml,the experiment using enzyme-linked immunosorbent assay?Enzyme linked immuno sorbent assay ELISA?method to test the RA experimental group and control group 0 weeks,12weeks and 24 weeks,25-hydroxyitamin D[25?OH?D]levels in serum levels,by monitoring 0 weeks,12 weeks,24 weeks,the experimental group and control group of25?OH?D level,analysis and disease activity score DAS28?DAS28?and related inflammatory indexes such as the correlation of the ESR and CRP.Results:1.Before treatment,the content of serum 25?OH?D in the experimental group was not significant with the content of 25?OH?D in the control group?t=0.298,P>0.05?,and there was no significant difference between the DAS28 score of the experimental group and the DAS28 score of the control group?t=1.847,P>0.05?.2.After 12 and 24 weeks after treatment,the serum levels of 25?OH?D in the experimental group and the control group were statistically different?F=7.09,P<0.01?.The ESR and CRP in the experimental group and the control group were statistically significant?F=11.26,P<0.01:F=3.48,P<0.01?after 12 and 24 weeks after treatment,and the DAS28 scores in the experimental group and the control group were statistically different after the treatment?F=4.38,P<0.01?.3.After twelfth,twenty-fourth weeks of treatment,the serum levels of 25?OH?D in the experimental group were correlated with ESR and CRP?R=-0.361,P<0.05;R=-0.634,P<0.05?.After twelfth,twenty-fourth weeks of treatment,the correlation between the serum 25?OH?D content of the experimental group with the DAS28score was statistically significant?R=-0.655,P<0.05?.Conclusion:1,25–dihydroxy vitamin D3 can improve the inflammatory indexes of ESR and CRP,reduce the DAS28 score of RA,improve the clinical symptoms of patients,and prove that 1,25–dihydroxy vitamin D3 plays a role in RA treatment.