血清25羟维生素D水平与急性缺血性脑卒中患者脑梗死体积及颈内动脉狭窄的关系  

Relationship between serum 25 hydroxyvitamin D level and cerebral infarction volume and internal carotid artery stenosis in patients with acute ischemic stroke

作　　者：陈梅鹃 王滔[2] 刘乐梅 文雯[1] 王利[1] CHEN Mei-juan;WANG Tao;LIU Le-mei;WEN Wen;WANG Li(Department of Geriatrics,Leshan People's Hospital,Leshan 614000,Sichuan,CHINA;Department of Geriatrics,Department of Radiology and Imaging,Leshan People's Hospital,Leshan 614000,Sichuan,CHINA)

机构地区：[1]乐山市人民医院老年病科,四川乐山614000 [2]乐山市人民医院放射影像科,四川乐山614000

出　　处：《海南医学》2021年第4期425-429,共5页Hainan Medical Journal

摘　　要：目的探讨血清25羟维生素D [25(OH)D]水平与急性缺血性脑卒中患者脑梗死体积及颈内动脉狭窄的关系。方法选取2018年10月至2019年10月乐山市人民医院诊治的200例急性缺血性脑卒中患者为研究对象,根据患者的颈部血管彩超结果分为颈内动脉正常组69例和颈内动脉狭窄组131例。根据梗死病灶体积大小将患者分为小体积组(梗死病灶体积≤1 cm^(3)) 108例、中体积组(1 cm^(3)<梗死病灶体积<20 cm^(3)) 48例和大体积组(梗死病灶体积≥20 cm^(3)) 44例。应用多因素Logistic回归方法分析脑梗死体积以及颈内动脉狭窄的影响因素,采用Pearson相关性分析血清25(OH)D水平与颈内动脉狭窄率和脑梗死体积的相关性。结果颈内动脉狭窄组患者的收缩压、舒张压、总胆固醇和低密度脂蛋白水平明显高于颈内动脉正常组,而25(OH)D水平明显低于颈内动脉正常组,差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示,收缩压、舒张压、总胆固醇和低密度脂蛋白是急性缺血性脑卒中患者颈内动脉狭窄的独立危险因素(P<0.05),而25(OH)D是其保护因素(P<0.05);大体积组患者的总胆固醇和低密度脂蛋白水平明显高于中体积组和小体积组,而25(OH)D水平明显低于中体积组和小体积组,中体积组总胆固醇和低密度脂蛋白水平明显高于小体积组,而25(OH)D水平明显低于小体积组,差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示,总胆固醇和低密度脂蛋白是急性缺血性脑卒中患者脑梗死体积的独立危险因素(P<0.05),而25(OH)D是其保护因素(P<0.05);Pearson相关性分析显示,血清25(OH)D水平与颈内动脉狭窄率和脑梗死体积均呈负相关性(r=-0.593、-0.562,P<0.05)。结论颈内动脉狭窄以及脑梗死体积较大的急性缺血性脑卒中患者血清25(OH)D水平下降,且25(OH)D是急性缺血性脑卒中患者脑梗死体积与颈内动脉狭窄的保护因素,在�Objective To investigate the relationship between serum 25 hydroxyvitamin D(25(OH)D)level and cerebral infarction volume and internal carotid artery stenosis in patients with acute ischemic stroke.Methods A total of 200 patients with acute ischemic stroke who were diagnosed and treated in Leshan People's Hospital from October 2018 to October 2019 were selected,the patients were divided into the normal internal carotid artery group(n=69)and internal carotid artery stenosis group(n=131)according to the results of color Doppler ultrasound of the neck vessels.The patients were divided into small volume group(n=108,infarct volume≤1 cm^(3)),middle volume group(n=48,1 cm^(3)<infarct volume<20 cm^(3)),large volume group(n=44,infarct volume≥20 cm^(3))according to the size of infarct.Multivariate logistic regression analysis was used to analyze the influencing factors of cerebral infarction volume and internal carotid artery stenosis.Pearson correlation analysis was used to analyze the correlation between serum 25(OH)D level and internal carotid artery stenosis rate and cerebral infarction volume.Results Systolic blood pressure,diastolic blood pressure,total cholesterol,and low-density lipoprotein in the internal carotid artery stenosis group were significantly higher than those in the normal internal carotid artery group,while the level of 25(OH)D was significantly lower than that of the normal internal carotid artery group(all P<0.05).Multivariate Logistic regression analysis showed that systolic blood pressure,diastolic blood pressure,total cholesterol and low-density lipoprotein were independent risk factors for internal carotid artery stenosis in patients with acute ischemic stroke(all P<0.05),while 25(OH)D was the protective factor(P<0.05).The levels of total cholesterol and low-density lipoprotein in the large volume group patients were significantly higher than those in the middle volume group and the small volume group,while the level of 25(OH)D was significantly lower than that of the middle volume group and

关 键 词：急性缺血性脑卒中 25羟维生素D 脑梗死体积 颈内动脉狭窄 相关性 

分 类 号：R743.3[医药卫生—神经病学与精神病学]