血清维生素D与高血压靶器官损害的相关研究

Correlational research of vitamin D and end-organ damage in patients with essential hypertension

目的了解血清维生素D在原发性高血压患者不同危险分层的水平变化,分析血清维生素D与原发性高血压合并不同靶器官损害的相关性,并探讨其临床意义。方法选取符合纳入标准的原发性高血压患者118例,按照原发性高血压危险分层标准分为低危组23例,中危组25例,高危组32组,极高危组38例。选取健康体检患者30例作为对照组。采用化学发光法测定每组患者血清维生素D水平,比较各组间差异,并分析维生素D水平与颈动脉内膜中层厚度(IMT)、左心室质量指数(LVMI)的相关性。结果高血压低危组、中危组、高危组、极高危组的血清维生素D水平均低于正常对照组[(27.88±5.34)ng/ml,(23.05±6.74)ng/ml,(19.31±8.08)ng/ml,(17.36±2.66)ng/ml vs.(30.08±4.77)ng/ml,P<0.05],且高血压极高危组、高危组的血清维生素D水平明显低于中危组、低危组(P<0.05)。血清维生素D与IMT、LVMI存在负相关(偏回归系数b值分别为-18.373、-0.021,P<0.10)。结论原发性高血压患者血清维生素D水平降低,尤其是伴有心脏、血管损害的患者维生素D水平降低更明显。维生素D与高血压的发生及发展有一定相关性,可作为高血压病理进展的一个重要预测因子,指导高血压患者的临床诊疗和预后评估。

Objective To observe the serum levels of vitamin D in patients with different risk stratification of essential hypertension, and to explore the relationship between vitamin D level and end-organ damages in the heart, and vessels of patients with essential hypertension. Methods A total of 118 patients diagnosed as essential hypertension were participated in the study. According to the primary hypertension risk stratification standard, all the patients were divided into four groups：low risk group of 23 cases, moderate risk group of 25 cases, high-risk groups of 32 cases and extremely dangerous group of 38 cases, and 30 normal controls enrolled in the study. Serum vitamin D levels of all the cases were evaluated by chemiluminescence method. The differences of serum vitamin D levels between five groups and the correlation between vitamin D levels and carotid intima-media thickness （IMT） and left ventricular mass index （LVMI） were analyzed. Results The concentrations of vitamin D in the four groups of essential hypertension were lower than that in the normal controls [（27.88±5.34）ng/ml, （23.05±6.74）ng/ml, （19.31±8.08）ng/ml, （17.36±2.66）ng/ml vs. （30.08±4.77）ng/ml, P〈0.05], and the vitamin D levels in the extremely dangerous group and the high-risk group were obviously lower than that in low risk group and moderate risk group. Serum vitamin D levels was negatively related to IMT and LVMI （b=-18.373, b=-0.021, P〈0.10）. Conclusion Serum vitamin D levels in patients with essential hypertension reduced, and especially lower then that in the patients with damage to the heart, blood vessel and other end-organ.Vitamin D could be an important forecast factor in the pathological progress of hypertension.