冠状动脉狭窄程度与血清25(OH)D_3的关系探讨
摘要
目的分析冠状动脉狭窄程度与血清25羟基维生素D_3[25(OH)D_3]的关系。方法回顾性分析我院2016年8月—2017年5月收治的符合纳入标准的冠心病病人112例。所有病人均测定血清25(OH)D_3含量。根据病人血清25(OH)D_3水平,将25(OH)D_3<15.0 nmol/L作为Q1组(24例),15.0～22.1 nmol/L作为Q2组(33例),22.2～35.6 nmol/L作为Q3组(25例),>35.6 nmol/L作为Q4组(30例)。比较病人尿酸、C反应蛋白(CRP)、阿司匹林用药情况、冠状动脉狭窄评分变化,并应用Logistic逐步回归分析冠状动脉狭窄程度与血清25(OH)D_3的相关性。结果 Q1组、Q2组和Q3组尿酸、他汀类药物及阿司匹林使用率均低于Q4组(P<0.05),CRP水平均高于Q4组(P<0.05);Q1组与Q2组冠状动脉狭窄评分均高于Q3、Q4组,差异有统计学意义(P<0.05)。Logistic逐步回归分析发现:高血压病程、吸烟及CRP为冠状动脉狭窄的独立危险因素;血清25(OH)D_3为其独立保护因素。结论低水平血清25(OH)D_3与冠状动脉狭窄有关。
引文
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[14] 杨文琦,魏剑芬,李树民,等.冠心病病人左室肥厚与维生素D、室性心律失常及NT-proBNP的相关性分析[J].中西医结合心脑血管病杂志,2017,15(8):910-913.
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[2] 李晖,高翠荣,李鲁,等.血清25羟维生素D3和C反应蛋白与冠心病的相关性[J].中华临床营养杂志,2015,23(1):8-11.
[3] 胡战,方颖.维生素D与冠状动脉粥样硬化及其危险因素的相关性研究[J].贵阳医学院学报,2015,40(12):1398-1401.
[4] OZ F,CIZGICI A Y,TOPUZ M,et al.Vitamin D insufficiency is associated with coronary artery tortuosity[J].Kardiol Pol,2017,75(2):174-180.
[5] 赵春芝,朱正太,李华,等.老年2型糖尿病患者血清25-OH维生素D与冠心病关系的研究[J].中国医药指南,2013(33):163-164.
[6] VERDOIA M,SCHAFFER A,SARTORI C,et al.Vitamin D deficiency is independently associated with the extent of coronary artery disease[J].Eur J Clin Invest,2014,44(7):634-642.
[7] LI K,YANG X,WANG L,et al.Modification of the association between smoking status and severity of coronary stenosis by vitamin D in patients suspected of coronary heart disease[J].Medicine (Baltimore),2016,95(36):e4817.
[8] 宋文信,黄国鹏,刘代菊,等.冠状动脉粥样硬化性心脏病患者体内维生素D水平变化的研究[J].重庆医学,2016,45(16):2250-2251.
[9] 潘楠楠,孟佳,迟啸威,等.维生素D受体基因多态性与冠心病的相关性[J].中国骨质疏松杂志,2015,21(12):1526-1528.
[10] 周广朋,张景岚,李刚,等.2型糖尿病合并冠心病患者维生素D、脂联素的表达水平及临床意义[J].贵州医药,2016,40(9):922-923.
[11] HO J S,CANNADAY J J,BARLOW C E,et al.Low 25-OH vitamin D levels are not associated with coronary artery calcium or obstructive stenoses[J].Coron Artery Dis,2015,26(6):521-525.
[12] LIEW J Y,SASHA S R,NGU P J,et al.Circulating vitamin D levels are associated with the presence and severity of coronary artery disease but not peripheral arterial disease in patients undergoing coronary angiography[J].Nutr Metab Cardiovasc Dis,2015,25(3):274-279.
[13] WETMORE J B,GADI R,LEE J H,et al.Association of 25-hydroxyvitamin D deficiency with NT-pro BNP levels in patients with acute myocardial infarction:a cross-sectional analysis[J].BMC Res Notes,2011(4):542.
[14] 杨文琦,魏剑芬,李树民,等.冠心病病人左室肥厚与维生素D、室性心律失常及NT-proBNP的相关性分析[J].中西医结合心脑血管病杂志,2017,15(8):910-913.
[15] 闫伟,王有恒,任骞,等.冠心病患者维生素D浓度与颈动脉内中膜厚度相关性研究[J].陕西医学杂志,2015(3):321-323.