血清维生素D与冠状动脉粥样硬化性心脏病患者冠状动脉病变严重程度及短期预后的相关性研究  

Correlation between serum vitamin D and coronary artery lesion severity and short-term prognosis in patients with coronary artery disease

作　　者：范益博 幺天保[1] 马珺[1] 袁安彩 杜勇平[1] 邵琴[1] 卜军[1] FAN Yi-bo;YAO Tian-bao;MA Jun;YUAN An-cai;DU Yong-pin;SHAO Qin;BU Jun(Department of Cardiology,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China;Shanghai Pudong New Area People's Hospital,Shanghai 201299,China)

机构地区：[1]上海交通大学医学院附属仁济医院心内科,上海200127 [2]上海市浦东新区人民医院,上海201299

出　　处：《上海交通大学学报（医学版）》2020年第7期889-893,共5页Journal of Shanghai Jiao tong University:Medical Science

基　　金：国家自然科学基金(81870338,81570390);上海市自然科学基金(19ZR1430300)。

摘　　要：目的·探讨血清维生素D水平与冠状动脉粥样硬化性心脏病(冠心病)患者冠状动脉病变严重程度及短期预后的关系。方法·连续纳入经冠状动脉造影诊断为冠心病的住院患者共323例,根据冠状动脉造影结果采用Gensini评分法进行评分,同时收集患者各项临床资料及测定血清维生素D等相关指标进行统计学分析。结果·根据Gensini评分对所有冠心病患者进行三分位分组,最低三分位组至最高三分位组患者的平均维生素D水平比较,差异有统计学意义(P=0.000)。经过线性相关分析后发现,冠心病患者的血清维生素D水平与Gensini评分(r=-0.182,P=0.001)具有负相关性;多元线性分析表明,冠心病患者的血清维生素D水平与Gensini评分(β=-0.795,P=0.000)呈独立负相关。经过平均(18.14±3.04)个月的随访,维生素D缺乏组患者主要心血管不良事件发生率与维生素D水平正常组比较,差异无统计学意义(2.05%vs 3.17%,P=0.202)。结论·冠心病患者的血清维生素D水平与冠状动脉病变严重程度具有独立相关性。Objective·To explore the relationship between serum vitamin D level and coronary artery lesion severity and short-term prognosis in coronary artery disease(CAD)patients.Methods·A total of 323 CAD patients diagnosed according to coronary angiogram were selected and the coronary artery lesion severity was evaluated by using Gensini score.Clinical data was collected and serum level of vitamin D and other indicators were determined for statistical analysis.Results·All patients were divided into tertile according to Gensini score.The level of serum vitamin D concentration was significantly different from the lowest tertile to the highest tertile(P=0.000).Serum vitamin D level was negatively correlated with Gensini score in CAD patients(r=-0.182,P=0.001).Multivariate linear analysis showed that vitamin D level was an independent predictor of Gensini score(β=-0.795,P=0.000).There was no difference in the incidence of major advanced cardiovascular events between vitamin D deficiency patients and normal vitamin D level patients(2.05%vs 3.17%,P=0.202)after(18.14±3.04)months'follow-up.Conclusion·There is an independently negative correlation between serum vitamin D and coronary artery lesion severity in CAD patients.

关 键 词：冠状动脉粥样硬化性心脏病 维生素D GENSINI评分 

分 类 号：R541.4[医药卫生—心血管疾病]