血清25-羟基维生素D水平与急性缺血性脑卒中短期预后的关系

Correlation between serum 25-hydroxyvitamin D levels and short-term prognosis of acute ischemic stroke

目的:探讨血清25-羟基维生素D[25-hydroxyvitamin D,25(OH)D]水平与急性缺血性脑卒中患者短期预后之间的关系。方法:连续收集2015年5月至11月于中国医科大学附属盛京医院神经内科住院治疗的急性缺血性脑卒中患者200例,收集临床资料,测定血清25(OH)D水平并进行入院美国国立卫生研究院卒中量表(NIH Stroke Scale,NIHSS)评分,发病90 d后随访,行改良Rank量表(Modified R ankin Scale,m R S)评分。根据血清25(OH)D水平、m R S评分分组,比较两组资料。结果:200例患者进入研究队列,90 d后失访13例,失访率为6.5%,94例(47%)患者发生预后不良事件。25(OH)缺乏组165例,年龄、脑血管病史、入院NIHSS评分、90 d m RS评分、胱抑素C水平、D-二聚体水平大于非缺乏组(P<0.05);90 d预后不佳组94例,25(OH)D水平低于预后良好组,房颤、脑血管病史、D-二聚体、NIHSS评分高于预后良好组;多因素分析显示血清25(OH)D水平(OR=0.895,95%CI 0.840~0.953,P=0.001)、入院NIHSS评分(OR=1.811,95%CI 1.428~2.296,P<0.001)与急性缺血性脑卒中短期预后密切相关。结论:血清25(OH)D水平是急性缺血性脑卒中短期预后的独立预测因子且是保护性因素。

Objective： To discuss the correlation between serum 25-hydroxyvitamin D [25（OH）D] levels and the shortterm prognosis of the patients with acute ischemic stroke. Methods： Two hundred patients with acute ischemic stroke were assessed from May 2015 to November 2015. Clinical data about prognosis of acute stroke patients were obtained at admission. The serum 25（OH）D levels were measured and the NIH Stroke Scale（NIHSS） was evaluated at admission. The outcomes were followed up at the onset of 90 days, carrying on the marks of the Modified Rankin Scale（m RS） score. The two groups of data were compared according to m RS score and serum 25（OH）D levels. Results： Two hundred patients were assessed in the study cohort, including 13 cases of lost to follow-up, lost to follow-up rate was 6.5%, a total of 94 cases（47%） in patients with poor prognosis. Lack of serum 25（OH）D group, a total of 165 cases, NIHSS score and m RS score, the urinary inhibition C level, D-dimer level and the average age greater than the not lack of group（P〈0.05）; 94 patients with poor prognosis in 90 days, 25（OH）D were lower than the prognostic group, atrial fibrillation, cerebrovascular history, D-dimer, NIHSS score were higher than the prognostic group; multiple factors analysis showed that the serum 25（OH）D levels（OR =0.895, 95% CI 0.840–0.953, P=0.001）, hospital NIHSS score（OR =1.811, 95% CI 1.428–2.296, P〈0.001） were closely related to the short-term prognosis of acute ischemic stroke. Conclusion： The serum 25（OH）D level is an independent predictor of short-term prognosis of acute cerebral ischemic stroke and is protective factors.