慢性心力衰竭患者血清25-羟维生素D3水平检测及其意义

Detection of serum 25-hydroxy vitamin D3 level in patients with chronic heart failure and its significance

目的探讨血清25-羟维生素D3[25(OH)D3]与慢性心力衰竭严重程度的相关性,评估其对心力衰竭患者的临床意义。方法选取2015年12月至2016年5月期间上海交通大学医学院附属同仁医院心血管内科收治的符合《2014中国心力衰竭诊断和治疗指南》诊断标准的患者152例,其中男性78例,女性74例,年龄(72.7±12.7)岁。根据美国纽约心脏病协会(NYHY)心功能分级分为NYHAⅠ级组(A组)44例、NYHAⅡ级组(B组)51例和NYHAⅢ~Ⅳ级组(C组)57例。通过检测患者血清25(OH)D3和其他生化指标水平,分析三组患者之间的差异以及25(OH)D3和慢性心力衰竭严重程度的相关性。根据数据类型分别采用t检验、方差分析、LSD法或x^2检验比较组间差异。线性回归分析25(OH)D3和心力衰竭相关因素的关系。结果三组患者脑钠肽(BNP)、左室射血分数(LVEF)、血红蛋白(Hb)水平差异有统计学意义(P<0.05)。A,B,C组患者25(OH)D3水平分别为(22.53±8.17),(18.13±6.69),(14.55±6.09)ng/ml,差异有统计学意义(P<0.05)。LSD法结果表明,A组患者25(OH)D3水平显著高于B组和C组患者,差异有统计学意义(P<0.05)。线性相关分析结果提示,25(OH)D3水平与BNP、年龄呈负相关(P=0.000,P=0.002),与LVEF呈正相关(P=0.000)。结论血清25(OH)D3水平与慢性心力衰竭严重程度负相关,补充维生素D是否有助于改善症状和预后则需大规模的研究进一步证实。

Objective To investigate the correlation of serum level of 25-hydroxy vitamin D3（25（OH）D3）with the severity of heart failure,and evaluate its clinical value.Methods A total of 152 patients who met the diagnostic criteria of 2014 Chinese Heart Failure Diagnosis and Treatment Guidelines were recruited in this study.They were 78 males and 74 females, at an age of （72.7 ±12.7）years,and according to the results of the New York Heart Association（NYHA）Functional Classification, they were assigned into NYHA-Ⅰgroup（group A,n=44）,NYHA-Ⅱgroup（group B,n=51）and NYHA-Ⅲ-Ⅳgroup（group C,n=57）. After serum 25（OH）D3 level and other biochemical indices were detected,the differences in the 3 groups and the correlations of the serum 25（OH）D3 level with the severity of chronic heart failure were analyzed.All the data were analyzed by SPSS statistics 19.0, and Student＇s t test,analysis of variance,least significant difference（LSD）test and Chi-square test were adopted for intergroup com-parison.Linear regression analysis was employed to analyze the correlation of the 25（OH）D3 level with heart failure.Results There were significant differences in brain natriuretic peptide（BNP）,left ventricular ejection fraction（LVEF）and hemoglobin（Hb）in the 3 groups（P〈0.05）.The 25（OH）D3 level was（22.53 ±8.17）,（18.13 ±6.69）and（14.55 ±6.09）ng/ml respectively in the groups A,B and C,and significant difference was seen among them（P〈0.05）.The results of LSD test showed that the level of 25（OH）D3 was significantly higher in group A than in group B and group C（P〈0.05）.The linear regression correlation analysis indicated that the level was negatively correlated with BNP and age（P=0.000,P=0.002）,but positively with LVEF（P=0.000）. Conclusion 25（OH）D3 level is negatively correlated with the severity of chronic heart failure.But whether vitamin D supplementa-tion is beneficial to alleviating symptoms and improving prognosis needs further large -scale study.