血浆25(OH)维生素D水平对冠状动脉旁路移植术后新发心房颤动的影响  

Influences of Plasma Vitamin D Level on Atrial Fibrillation after Coronary Artery Bypass Grafting

作　　者：钟世虎[1] 凌生林[1] 叶彬[1] 茹小虎 ZHONG Shihu;LING Shenglin;YE Bin;RU Xiaohu(Yibin First People′s Hospital,Yibin 644000,Sichuan,China)

机构地区：[1]宜宾市第一人民医院,四川宜宾644000

出　　处：《中西医结合心脑血管病杂志》2020年第17期2882-2886,共5页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：宜宾市科技局重点科研项目(No.2014SF12)。

摘　　要：目的探讨血浆25(OH)维生素D水平对冠状动脉旁路移植术(CABG)后新发心房颤动(POAF)的影响。方法选取2017年1月—2019年1月在我院接受CABG的冠心病病人112例作为研究对象,采用单因素和多因素分析25(OH)维生素D对POAF的影响,采用受试者工作特征(ROC)曲线计算25(OH)维生素D预测POAF的临床价值。结果单因素分析显示,POAF和非POAF病人年龄、高血压、糖尿病、C反应蛋白(CRP)、总胆固醇、低密度脂蛋白胆固醇、25(OH)维生素D、左室射血分数比较,差异均有统计学意义(P<0.05)。多因素分析显示,年龄、CRP是POAF发生的危险因素(P<0.05),25(OH)维生素D是POAF发生的保护性因素(P<0.05)。ROC分析显示,25(OH)维生素D预测POAF的灵敏度为0.897,特异性为0.588,截断值为7.75 ng/mL,曲线下面积为0.810。结论血浆25(OH)维生素D水平是POAF发生的保护性因素,低水平的25(OH)维生素D是导致POAF发生的重要原因。Objective To investigate the effect of plasma vitamin D level on atrial fibrillation after coronary artery bypass grafting(CABG).Methods One hundred and twelve patients with coronary heart disease who received CABG in our hospital from January 2017 to January 2019 were selected as the study subjects.The effects of 25(OH)vitamin D on postoperation atrial fibrillation(POAF)were observed by univariate and multivariate analysis,and the clinical value of 25(OH)vitamin D in predicting POAF was calculated using receiver operating characteristic(ROC).Results The univariate analysis showed that there were significant differences in age,hypertension,diabetes,CRP,TC,LDL-C,25(OH)vitamin D,and LVEF between POAF and non-POAF groups(P<0.05).The multivariate analysis showed that age and CRP were risk factors for POAF,and 25(OH)vitamin D was protective factor for POAF(P<0.05).The ROC showed that,the sensitivity was 0.897,specificity was 0.588,cut-off was 7.75 ng/mL,area under the curve was 0.810 of 25(OH)vitamin D in predicting POAF.Conclusion The plasma vitamin D level is a protective factor for POAF,and the low level of vitamin D is an important reason for POAF.

关 键 词：冠心病 冠状动脉旁路移植术 心房颤动 C反应蛋白 25(OH)维生素D 

分 类 号：R541.4[医药卫生—心血管疾病] R256.2[医药卫生—内科学]