血清25-羟维生素D水平和腔隙性梗死患者血管周围间隙扩大的相关性

Correlation between serum 25-hydroxyvitamin D level and enlarged perivascular spaces in patients with lacunar infarction

目的探讨血清25一羟维生素D[25-hydroxyvitamin D，25（OH）D]水平和腔隙性梗死患者血管周围间隙扩大（enlarged perivascular spaces，EPVS）的相关性。方法连续纳入住院治疗的急性腔隙性梗死患者。采用化学发光免疫分析法测定血清25（OH）D水平，头颅MR／评估半卵圆中心和基底节区EPVS严重程度（1级：0～10个；2级：11～25个；3级：〉25个）。采用单变量分析不同EPVS严重程度组之间基线资料的差异，采用有序多变量logistic回归分析探讨25（OH）D水平与EPVS严重程度的独立相关性。结果总共纳入194例患者，男性96例（49．5％），平均年龄（63．4±9．3）岁。平均基线NIHSS评分为（2．0±1．7）分，平均25（014）D水平为（50．25±15．50）nrnol／L。半卵圆中心EPVS1级、2级和3级的患者分别有112例（57．7％）、45例（23．2％）和37例（19．1％），基底节区EPVS1级、2级和3级的患者分别有109例（56．2％）、53例（27．3％）和32例（16．5％）。有序多变量logistic回归分析显示，25（OH）D水平与半卵圆中心（优势比2．898，95％可信区间1．345～9．612；P=0．028）和基底节区（优势比2．688，95％可信区间1．182～10．281；P=0．039）EPVS严重程度显著独立相关。结论血清25（OH）水平与腔隙性梗死患者EPVS严重程度独立相关。

Objective To investigate the correlation between serum 25-hydroxyvitamin D （25（OH） D） level and enlarged perivascular spaces （EPVS） in patients with lacunar infarction. Methods Consecutive inpatients with acute lacunar infarction were enrolled. Chemiluminescence immunoassay was used to measure the serum 25（OH）D. Head MRI was used to assess the severity of EPVS in the centrum ovale and the basal ganglia region （grade 1, 0-10; grade 2, 11-25; grade 3, 〉25）. Univariate analysis was used to analyze the differences in baseline data among the three groups. Multivariate ordinal logistic regression analysis was used to investigate the independent correlation between the 25（OH）D levels and the severity of EPVS. Results A total of 194 patients were enrolled, 96 were males. Their mean age was 63.4 ±9. 3 years. The mean baseline National Institutes of Health Stroke Scale （NIHSS） score was 2.0 ± 1.7. The mean 25（OH）D level was （50.25± 15.50）nmol/L. There were 112 patients （57.7%）, 45 （23.2%） and 37 （19. 1%） with EPVS grade 1, grade 2 and grade 3 in the centrum ovale, and 109 （56. 2%）, 53 （27.3%） and 32 （16. 5%） with EPVS grade I, grade 2 and grade 3 in basal ganglia region, respectively. Multivariate ordinal logistic regression analysis showed that serum 25（OH）D levels were independently associated with the severity of EPVS in the centrum ovale （odds ratio 2. 898, 95% confidence interval 1. 345-9. 612; P = 0. 028） and basal ganglia region （odds ratio 2. 688, 95% confidence interval 1. 182-10. 281; P = 0. 039）. Conclusion The low serum 25 （OH） D levels are independently associated with the severity of EPVS in patients with lacunar infarction.