【摘要】 目的 探讨生物可利用度维生素D(BAVD)在抗磷脂抗体(aPLs)阳性的复发性流产(RSA)患者中的临床意义。方法 收集2020年1月至2022年6月就诊于绵阳市中心医院风湿免疫科的93例流产患者，根据有无RSA分为RSA组62例和无RSA组31例，再根据有无aPLs将RSA组分为aPLs阳性RSA组37例和aPLs阴性RSA组25例，并对其BAVD与aPLs进行相关性分析。结果 RSA组的BAVD水平显著低于无RSA组(P<0.05);aPLs阳性RSA组BAVD的水平显著低于aPLs阴性RSA组(P<0.05)。在RSA组中BAVD与aβ2GP1-IgM、aPS/PT-IgM、LA1/LA2负相关；在aPLs阳性RSA组中BAVD与aPS/PT-IgM、LA1/LA2负相关(P<0.05)。BAVD是aPLs阳性RSA的保护性因素；BAVD预测aPLs阳性RSA曲线下面积(AUC)高于游离25羟维生素D[f-25(OH)D]。结论 研究显示BAVD水平降低与aPLs阳性的RSA发生风险显著相关。BAVD不仅是aPLs阳性RSA患者的保护性因素，且其预测价值优于f-25(OH)D,提示BAVD可能在aPLs介导的复发性流产病理机制中发挥重要作用。更多还原

【Abstract】 Objective To investigate the clinical significance of bioavailable vitamin D(BAVD) in recurrent spontaneous abortion(RSA) patients with positive antiphospholipid antibodies(aPLs).Methods Ninety-three abortion patients who attended the Department of Rheumatology and Immunology of Mianyang Central Hospital from January 2020 to June 2022 were collected. The patients were divided into a RSA group(n=62) and a no-RSA group(n=31) according to the presence or absence of RSA. The RSA group was further divided into an aPLs-positive RSA group(n=37) and an aPLs-negative RSA group(n=25) according to the presence or absence of aPLs. The correlation between BAVD and aPLs was analyzed.Results The BAVD levels in the RSA group were significantly lower than those in the non-RSA group(P<0.05). The BAVD levels in the aPLs-positive RSA group were significantly lower than those in the aPLs-negative RSA group(P<0.05). In the RSA group, BAVD was negatively correlated with aβ2GP1-IgM, aPS/PT-IgM, and LA1/LA2(P<0.05). In the aPLs-positive RSA group, BAVD was negatively correlated with aPS/PT-IgM, LA1/LA2. BAVD was a protective factor. The areas under the ROC curve(AUC) for BAVD in predicting aPLs positivity was higher than that for free 25-hydroxyvitamin D [f-25(OH)D].Conclusions Reduced levels of BAVD are significantly associated with an elevated risk of RSA in patients with positive aPLs. BAVD not only serves as a protective factor against aPLs-positive RSA but also exhibits superior predictive value compared to f-25(OH)D. These results suggest that BAVD may play an important role in the pathological mechanism of recurrent spontaneous abortion mediated by aPLs.更多还原