心力衰竭患者25-羟基维生素D3缺乏与血管内皮功能异常及动脉粥样硬化程度的相关性分析  

Correlation analysis of 25-hydroxyvitamin D3 deficiency with vascular endothelial dysfunction and atherosclerosis degree in patients with heart failure

作　　者：黄文霞[1] 李海涛[1] 黄玉冰[1] 廖旺[1] HUANG Wen-xia;LI Hai-tao;HUANG Yu-bing;LIAO Wang(Department of Cardiovascular Medicine,Hainan People's Hospital,Hainan Hospital Affiliated to Hainan Medical College,Haikou 570311,Hainan,China)

机构地区：[1]海南省人民医院•海南医学院附属海南医院心血管内科,海南海口570311

出　　处：《川北医学院学报》2022年第5期593-596,629,共5页Journal of North Sichuan Medical College

基　　金：海南省自然科学基金项目(814319)。

摘　　要：目的:分析心力衰竭患者25-羟基维生素D3[25(OH)D3]缺乏与血管内皮功能异常及动脉粥样硬化程度的相关性。方法:根据入院时25(OH)D3水平将80例心力衰竭患者分为25(OH)D3缺乏组(n=48)和非25(OH)D3缺乏组(n=32)。以反应性充血指数(RHI)作为血管内皮功能评估指标,取颈动脉内膜中膜厚度(IMT)作为动脉粥样硬化程度的评估指标。对比两组RHI、IMT水平,采用Pearson分析25(OH)D3与RHI、IMT的相关性。采用多元逐步回归分析模型研究影响心力衰竭患者RHI、IMT值的危险因素。结果:25(OH)D3缺乏组RHI低于非25(OH)D3缺乏组,IMT高于非25(OH)D3缺乏组(P<0.05)。25(OH)D3与RHI呈正相关关系(r=0.595,P<0.001),与IMT呈负相关关系(r=-0.423,P<0.001)。总胆固醇(TC)及25(OH)D3是心力衰竭患者RHI的影响因素;高密度脂蛋白(HDL-C)及25(OH)D3是心力衰竭患者IMT的影响因素。结论:25(OH)D3缺乏是血管内皮功能异常及动脉粥样硬化程度的独立危险因素,及时监测心力衰竭患者25(OH)D3水平有利于改善其临床预后转归。Objective:To analyze the correlation between 25-hydroxyvitamin D3[25(OH)D3]deficiency and vascular endothelial dysfunction and atherosclerosis degree in patients with heart failure.Methods:A total of 80 patients with heart failure were divided into 25(OH)D3 deficient group(n=48)and non-25(OH)D3 deficient group(n=32)according to the level of 25(OH)D3 at admission.Reactivity hyperemia index(RHI)was used as the evaluation index of vascular endothelial function,and carotid intima-media thickness(IMT)was used as the evaluation index of atherosclerosis.The levels of RHI and IMT were compared between the two groups,and the correlation between 25(OH)D3 and RHI and IMT was analyzed by Pearson.Multiple step-up regression analysis model was used to study the risk factors affecting RHI and IMT values in patients with heart failure.Results:RHI of 25(OH)D3 deficiency group was lower than that of non-25(0 H)D3 deficiency group,IMT was higher than that of non-25(0 H)D3 deficiency group(P<0.05).25(OH)D3 was positively correlated with RHI(r=0.595,P<0.001)and negatively correlated with IMT(r=-0.423,P<0.001).TC and 25(OH)D3 were the influencing factors of RHI in patients with heart failure.Hdl-c and 25(OH)D3 were influencing factors of IMT in patients with heart failure.Conclusion:25(OH)D3 deficiency in patients is an independent risk factor for vascular endothelial dysfunction and atherosclerosis,and timely monitoring of 25(OH)D3 level in patients with heart failure can improve their clinical prognosis.

关 键 词：心力衰竭 25-羟基维生素D3 血管内皮功能异常 动脉粥样硬化程度 反应性充血指数 颈动脉内膜中膜厚度 

分 类 号：R720.597[医药卫生—急诊医学]