血清维生素D与急性脑梗死及其预后的关系  

Correlation between serum vitamin D level and prognosis in patients with acute cerebral infarction

作　　者：肖雅娟[1] 冯利东[2] 

机构地区：[1] 包头市第四医院神经内科,014030 [2] 包钢集团第三职工医院神经内科

出　　处：《中国医师进修杂志》2017年第3期200-203,共4页Chinese Journal of Postgraduates of Medicine

基　　金：包头市科技局基金（2014s2003-2-5）

摘　　要：目的 探讨血清维生素D与急性脑梗死的关系及其对脑梗死患者预后的影响.方法 选择发病在48 h内的急性脑梗死患者100例,另选取健康体检者60例,检测血清25V羟基维生素D水平,并根据血清25V羟基维生素D水平将急性脑梗死患者分为维生素D充足组、维生素D不足组和维生素D缺乏组.在入院当天和治疗14 d采用美国国立卫生研究院卒中量表（NIHSS）进行评分,判定近期预后;治疗3个月采用改良Rankin量表（mRS）评价远期预后.结果 急性脑梗死患者血清25V羟基维生素D水平明显低于健康对照者[（14.21±0.98）μg/L比（22.43±1.01）μg/L],差异有统计学意义（t=3.95,P=0.012）.急性脑梗死患者依据血清25V羟基维生素D水平进行分组,其中维生素D充足组19例,维生素D不足组28例,维生素D缺乏组53例.维生素D充足组入院时和治疗14 d NIHSS评分明显低于维生素D不足组和维生素D缺乏组[（7.03±1.82）分比（10.21±2.03）和（14.35±2.96）分、（2.04±1.86）分比（5.21±2.28）和（10.38±2.34）分],维生素D不足组明显低于维生素D缺乏组,差异有统计学意义（P〈0.01）.Pearson相关性分析结果显示,血清25V羟基维生素D水平与入院时NIHSS评分呈负相关（r=-1.738,P=0.031）.维生素D充足组近期总有效率明显高于维生素D不足组和维生素D缺乏组[17/19比67.9%（19/28）和47.2%（25/53）],而维生素D不足组明显高于维生素D缺乏组,差异有统计学意义（P〈0.05）.维生素D充足组远期预后良好率明显高于维生素D不足组和维生素D缺乏组[18/19比75.0%（21/28）和50.9%（27/53）],维生素D不足组明显高于维生素D缺乏组,差异有统计学意义（P〈0.05）.结论 急性脑梗死患者血清维生素D水平明显降低,与神经功能缺损程度呈负相关,对判断预后有重要意义.Objective To investigate the relationship between serum vitamin D level and prognosis in patients with acute cerebral infarction. Methods One hundred patients with acute cerebral infarction within 48 h and 60 healthy subjects were selected. The serum 25-hydroxy-vitamin D level was measured. The patients with acute cerebral infarction were divided into vitamin D sufficient group, vitamin D insufficient group and vitamin D deficiency group according to the serum 25- hydroxy- vitamin D level. The National Institutes of Health stroke scale （NIHSS） before treatment and 14 d after treatment was evaluated, and this result reflected short- term prognosis; the long- term prognosis was evaluated by modified Rankin scale （mRS） 3 months after treatment. Results The serum 25-hydroxy-vitamin D level in patients with acute cerebral infarction was significantly lower than that in healthy subjects：（14.21 ± 0.98）μg/L vs. （22.43 ± 1.01）μg/L, and there was statistical difference （t=3.95, P=0.012）. The patients with acute cerebral infarction were divided into 3 groups according to the serum 25- hydroxy-vitamin D level：vitamin D sufficient group （19 cases）, vitamin D insufficient group （28 cases） and vitamin D deficiency group （53 cases）. The NIHSS before treatment and 14 d after treatment in vitamin D sufficient group was significantly lower than that in vitamin D insufficient group and vitamin D deficiency group： （7.03 ± 1.82） scores vs. （10.21 ± 2.03） and （14.35 ± 2.96） scores, （2.04 ± 1.86） scores vs. （5.21 ± 2.28） and （10.38 ± 2.34） scores, and that in vitamin D insufficient group was significantly lower than that in vitamin D deficiency group, and there were statistical differences （P〈0.01）. The Pearson correlation analysis result showed that the serum 25- hydroxy- vitamin D level was negatively correlated with NIHSS scores （r = -1.738, P = 0.031）. The short- term total effective rate in vitamin D sufficient group was significantly higher than that

关 键 词：脑梗塞 预后 美国国立卫生研究院卒中量表 

分 类 号：R743.3[医药卫生—神经病学与精神病学]