颈动脉IMT与老年冠心病患者维生素D水平的关系分析

Analysis of correlation between the level of vitamin D and intima- media thickness in patients with coronary heart disease

目的分析颈动脉内中膜厚度与老年冠心病患者维生素D浓度的关系,并讨论血清维生素D水平是否可以作为动脉粥样硬化的预测指标。方法选取自2013年5月到2015年5月的512例临床确诊为冠心病的患者,并检测其血脂、血糖、甲状旁腺素、C反应蛋白等生化指标,测定患者的血清维生素D水平,并利用超声测量颈动脉内中膜厚度。根据患者血清的维生素D水平并利用四分位数法将所有患者分为四组,Q1-Q4组,分析颈动脉内中膜厚度与血清维生素D水平的相关性。结果维生素D高浓度组（Q4组）血糖、C反应蛋白、甲状旁腺素、颈动脉内中膜厚度以及颈动脉斑块发生率均低于维生素D低浓度组（Q1组）,差异均具有统计学意义（P〈0.05）。颈动脉内中膜厚度与年龄、吸烟、BMI、糖尿病、C反应蛋白、低密度脂蛋白C、甲状旁腺素/维生素D呈正相关关系（P〈0.001）,与维生素D浓度呈负相关关系（P〈0.001）。结论对于老年冠心病患者,维生素D是颈动脉内中膜厚度增加的独立危险因素,因此,血清维生素D水平可以作为动脉粥样硬化的预测指标。

Objective To analyze the correlation between the level of vitamin D and intima- media thickness in patients with coronary heart disease. Methods 512 patients with coronary heart disease were chosen from our hospital. Blood sugar,blood fat,CPR,PTH and Vitamin D of 512 patients with coronary heart disease were tested,and their intima- media thickness of carotid artery was tested with ultrasound. They were divided into four groups（ Q1 Q4） according to the serial level of Vitamin D. The correlation between the level of vitamin D and intima-media thickness in patients with coronary heart disease was analyzed. Results The intima- media thickness,rate of carotid artery plaque,blood sugar,CRP,PTH had significant difference between the lower Vitamin D group and high Vitamin D group（ P〈0. 05）. The blood sugar of Q4 was significantly lower than the one of Q1（ P〈0. 001）. Intima- media thickness in group Q3 and Q4 was significant lower than that in group Q1（ P〈0. 001）. There were positive correlation between intima- media thickness and age,BMI,CRP,smoking,PTH/Vitamin D（ P〈0. 001）,but negative correlation between IMT and Vitamin D level by Pearson analysis（ P〈0. 001）. Conclusion The level of Vitamin D is independently associated with intima- media thickness and can be used to predict atherosclerosis.