维生素D、甲状旁腺激素与慢性心力衰竭的相关性分析

Relationship of vitamin D and parathyroid hormone in chronic heart failure

目的探讨维生素D和甲状旁腺激素(PTH)在慢性心力衰竭中的关系。方法选取2014年3月21日-2015年7月20日就诊于该院心内科的心力衰竭(以下简称心衰)患者500例,依据纽约心脏病学会心功能分级分为4组。分析维生素D、PTH水平与心衰的相关性。采用Logstic回归分析进行危险因素与高血压的相关性检验。结果 4组患者存在不同程度的维生素D缺乏。Pearson相关分析发现,维生素D与PTH呈负相关(r=-0.166,P=0.041),多元Logistic回归分析证实维生素D缺乏是心衰的独立危险因素[^OR=1.566(95%CI:1.036,2.369),P=0.034],PTH升高是心衰的独立危险因素[^OR=2.625(95%CI:1.016,6.785),P=0.046]。结论在慢性心衰的患者中,随着心衰分级的加重,维生素D缺乏越明显,而PTH正好呈相反的趋势,维生素D与PTH水平呈负相关,维生素D缺乏、PTH升高均是有症状心衰的独立危险因素。

Objective To observe the relationship of vitamin D and parathyroid hormone（PTH） in chronic heart failure. Methods A total of 500 patients with heart failure treated in our hospital from March 21, 2014 to July 20, 2015 were selected, and divided into four groups according to the NYHA heart function classification. The relationships of PTH and vitamin D levels with heart failure were analyzed. Logistic regression analysis was adopted for correlations between risk factors and high blood pressure. Results The patients of the four groups had different degree of vitamin D deficiency. Pearson correlation analysis revealed that vitamin D and PTH were in a negative correlation（r =-0.166, P = 0.041）. Multivariate logistic regression analysis confirmed that vitamin D deficiency [OR^ = 1.566（95% CI： 1.036, 2.369）, P = 0.034] and elevated PTH [OR^ =2.625（95% CI： 1.016, 6.785）, P = 0.046] were the independent risk factors for heart failure. Conclusions In the patients with chronic heart failure, vitamin D deficiency becomes more obvious with the aggravation of grading of heart failure, while PTH is just in an opposite trend. Vitamin D is negatively correlated to the level of PTH. Lack of vitamin D and elevation of PTH are the independent risk factors for symptomatic heart failure.