摘要目的 研究人体血清维生素D水平对泌尿生殖道沙眼衣原体(Chlamydia trachomatis,Ct)感染的影响.方法 征集2016年11月1日到2017年3月15日期间Ct检测阳性患者174名(男性95人,女性79人),健康志愿者380名(男性211人,女性169人),年龄均为20～49岁.分别取健康志愿者的晨起和Ct阳性患者抗生素治疗前1天、1个疗程结束后次日的晨起空腹血,用酶联免疫吸附法(ELISA)检测血清25-羟基维生素[25-(OH)D]浓度.治疗结束后1个月用PCR法对感染者判愈.采用病例对照研究设计从已采集的样本中按性别、年龄进行随机频数匹配,建立感染组和健康对照组(各161例),未治愈组和治愈组(各41例).使用SPSS19.0进行统计学分析,P<0.05为差异有统计学意义.结果 病例对照研究显示维生素D水平缺乏是Ct感染和疗效下降的危险因素(调整OR=2.281,95％CI:1.438～3.619;调整OR=7.266,95％CI:2.551～21.036).全部样本中20～39岁年龄组中男性感染者25-(OH)D水平[(40.10±17.93)nmol/L]低于健康男性[(53.72±18.00)nmol/L],女性感染者的25-(OH)D水平[(35.71±19.99)nmol/L]低于健康女性[(45.42±16.08)nmol/L],差异均有统计学意义(P均<0.01),1个疗程男性未愈者的25-(OH)D水平[(30.50±14.53)nmol/L]低于男性治愈者[(41.32±17.24)nmol/L],女性未愈者的25-(OH)D水平[(29.47±16.66)nmol/L]低于女性治愈者[(41.37±21.03)nmol/L],差异均有统计学意义(P均<0.05).结论 人泌尿生殖道Ct感染及治愈率降低与维生素D缺乏相关,血清维生素D水平降低可能会增加泌尿生殖道Ct感染风险,并降低疗效.

abstractsObjective To investigate the correlation between serum vitamin D level in human body and Chlamydia trachomatis (Ct) genitourinary tract infection. Methods This study enrolled 174 outpa-tients (male: 95, female: 79, 20-49 years) infected with Ct and 380 healthy subjects (male: 211, female:169, 20-49 years) in Tianjin from November 1, 2016 to March 15, 2017. Blood samples were collected from all subjects after fasting overnight and the time points for sample collection in the Ct infection group were before and after a course of antibiotic treatment. Serum 25-hydroxyvitamin D [25-(OH)D] levels were measured with enzyme-linked immunosorbent assay (ELISA). PCR assay was used to assess the recovery in those patients one month after a course of treatment. Two case-control studies were respectively conducted, in which 161 patients and 161 healthy subjects as well as 41 uncured patients and 41 cured patients were&nbsp;randomly selected and matched for gender and age. Statistical analysis was performed using SPSS19. 0. Re-sults The two case-control studies showed that vitamin D deficiency was a risk factor for both Ct genital tract infection and poor efficacy, of which the adjusted ORs were 2. 281 (95％ CI: 1. 438, 3. 619) and 7. 266 (95％ CI: 2. 551, 21. 036). Among all subjects aged 20-39, male patients had lower 25-(OH)D level in serum than healthy men [(40. 10±17. 93) nmol/ L vs (53. 72±18. 00) nmol/ L, P< 0. 01] and fe-male patients also had lower 25-(OH)D level in serum than healthy women [(35. 71±19. 99) nmol/ L vs (45. 42±16. 08) nmol/ L, P<0. 01]. The levels of 25-(OH)D in uncured male and female patients were re-spectively lower than those in cured male and female patients [(30. 50±14. 53) nmol/ L vs (41. 32±17. 24) nmol/ L; (29. 47±16. 66) nmol/ L vs (41. 37±21. 03) nmol/ L; both P<0. 05]. Conclusion Vitamin D deficiency related to Ct infection in human genitourinary tract and poor prognosis. Lower serum vitamin D levels might increase the risk of Ct genitourinary tract infection and reduce the efficacy of treatment.