血清25-羟维生素D_(3)水平与STEMI患者直接PCI术后恶性心律失常相关性研究  

The relationship between serum 25-hydroxyvitamin D_(3) level and malignant ventricular arrhythmia in patients with ST-segment elevation myocardial infarction after direct percutaneous coronary intervention

作　　者：田水[1] 巫廷春 田龙海[1] 叶芸[1] Tian Shui;Wu Tingchun;Tian Longhai;Ye Yun(Department of Cardiology,Guizhou Province People's Hospital,Guiyang 550002,China;Department of Cardiology,the Second Affiliated Hospital of Guizhou Medical University,Guiyang 550002,China)

机构地区：[1]贵州省人民医院心内科,贵阳550002 [2]贵州省中医药大学附二院心内科,贵阳550002

出　　处：《心脑血管病防治》2021年第4期353-356,共4页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

摘　　要：目的探讨血清25-羟维生素D_(3)[25-(OH)-D_(3)]水平与ST段抬高型心肌梗死(STEMI)患者直接经皮冠状动脉介入治疗(PCI)术后恶性室性心律失常(MVA)的关系。方法收集2016年3月至2019年3月在贵州省人民医院接受直接PCI治疗的STEMI患者90例进行回顾性研究,根据PCI术后48h是否发生MVA分为MVA组28例和非MVA组62例,比较两组间一般资料、实验室指标的差异,分析MVA的影响因素。结果MVA组多支病变的比例及入院后白细胞计数(WBC)、血糖(BG)、C反应蛋白(CRP)、脑钠肽(BNP)、肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)的水平明显高于非MVA组,25-(OH)-D_(3)的水平明显低于非MVA组(χ^(2)/t=9.060、6.960、6.255、11.575、8.005、13.674、5.358、6.264,P<0.05);血清25-(OH)-D_(3)水平与病变支数及WBC、CRP、BNP、BG、cTnI、CK-MB水平均呈负相关(r=-0.251、-0.244、-0.342、-0.294、-0.384、-0.291、-0.310,P<0.05);多支病变及WBC、CRP、BNP增加及25-(OH)-D_(3)缺乏是MVA的危险因素(Wald=6.022、7.981、9.187、5.477、7.587,P<0.05)。结论血清25-(OH)-D_(3)水平减少能够增加STEMI患者直接PCI术后MVA的发生风险,且与病情、炎症反应激活、心功能变化有关。Objective To explore the relationship between serum 25-hydroxyvitamin D_(3)[25-(OH)-D_(3)]level and malignant ventricular arrhythmia(MVA)in ST-segment elevation myocardial infarction(STEMI)patients after direct percutaneous coronary intervention(PCI).Methods A retrospective study was conducted on 90 STEMI patients treated with direct PCI in Guizhou province people's hospital from March 2016 to March 2019.According to the occurrence of MVA at 48 hours after PCI,patients were divided into MVA group(n=28)and non-MVA group(n=62).The differences of general data and laboratory indicators between the two groups were compared,and the influencing factors of MVA were analyzed.Results The ratio of multiple lesions and the levels of white blood cell count(WBC),blood glucose(BG),C-reactive protein(CRP),brain natriuretic peptide(BNP),cardiac troponin I(cTnI)and creatine kinase-MB(CK-MB)after admission were significantly higher than those in non-MVA group,25-(OH)-D_(3)level was significantly lower than that in non-MVA group(χ^(2)/t=9.060,6.960,6.255,11.575,8.005,13.674,5.358,6.264;P<0.05);serum 25-(OH)-D_(3)levels were negatively correlated with the number of lesion branches and WBC,CRP,BNP,BG,cTnI,CK-MB levels(r=-0.251,-0.244,-0.342,-0.294,-0.384,-0.291,-0.310;P<0.05).Multiple lesions,the increase of WBC,CRP,BNP and deficiency of 25-(OH)-D_(3)were risk factors for MVA(Wald=6.022,7.981,9.187,5.477,7.587;P<0.05).Conclusion Reduced serum 25-(OH)-D_(3)level can increase the occurrence risk of MVA in STEMI patients after direct PCI,and it is also related to the condition,activation of inflammatory response and the changes of cardiac function.

关 键 词：ST段抬高型心肌梗死 经皮冠状动脉介入术 恶性室性心律失常 25-羟维生素D_(3) 

分 类 号：R542.22[医药卫生—心血管疾病] R541.7[医药卫生—内科学]