脑梗死患者尿微量白蛋白与血清25-羟维生素D水平相关性

Correlation between urinary microalbumin and serum 25-hydroxy vitamin D levels in patients with cerebral infarction

目的研究脑梗死患者尿微量白蛋白(MAU)与血清25-羟维生素D水平的关系。方法随机收取2016年12月至2017年5月在新疆医科大学第一附属医院就诊的脑梗死患者240例,男性141例,女性99例,平均年龄(60.84±11.60)岁,根据MAU测定结果将患者分为MAU正常组及MAU异常组,收集患者的一般资料及实验室指标,分析MAU与血清25-羟维生素D的关系。结果病例组25-羟维生素D水平(23.84±18.33)nmol·L^(-1)低于对照组的(32.24±15.80)nmol·L^(-1),差异有统计学意义(Z=-3.961,P<0.001)。其中对照组血清25-羟维生素D缺乏或者不足者184例(98.40%),充足者3例(1.60%)。病例组缺乏或者不足者50例(94.34%),充足者3例(5.67%)。MAU为因变量进行二元Logistic回归分析显示,高血压、空腹血糖、高密度脂蛋白、低密度脂蛋白、三酰甘油与高MAU发生相关(P<0.05)。其中高血压、三酰甘油对MAU白影响较大,其相对危险度分别为对照组的4.773倍、3.199倍。血清25-羟维生素D经Pearson相关分析,其与MAU、高密度脂蛋白呈负相关(P<0.05)。结论脑梗死患者存在25-羟维生素D不足或者缺乏,MAU与血清25-羟维生素D呈负相关,故应该重视脑梗死患者25-羟维生素D不足现象,建议适当补充维生素D。

Objective To study the relationship between microalbuminuria（MAU） and 25-hydroxy vitamin D levels in patients with cerebral infarction. Method From December 2016 to May 2017 were charged in 240 cases of the First Affiliated Hospital of Xinjiang Medical University in cerebral infarction patients, including 141 cases of male, female 99 cases, mean age 60.84±11.60 years old, according to MAU determination results were divided into normal MAU group and MAU in abnormal group, general information and laboratory indexes were collected and the relationship between MAU and serum 25-hydroxy vitamin D. Results 25-hydroxy vitamin D was 23.84±18.33 nmol·L^（-1） that lower than the control group, the difference was statistically significant（Z=3.961, P〈0.001）. Among them, 184 cases（98.40%） of 25-hydroxy vitamin D deficiency or insufficiency in control group, 3 cases（1.60%） were enough. There were 50 cases（94.34%） lacking or insufficient in the case group, and 3 cases（5.67%） in sufficiency. MAU as dependent variable was Logistic regression analysis showed that hypertension, fasting blood glucose, high density lipoprotein, low density lipoprotein, triglyceride and high MAU associated（P〈0.05）. Among them, hypertension and triglyceride have great influence on MAU, and the relative risk is 4.773 times and 3.199 times as high as that of the control group. Analysis of serum 25-hydroxy vitamin D by Pearson, and the MAU, high density lipoprotein cholesterol was negatively correlated（P〈0.05）. Conclusion Patients with cerebral infarction, 25-hydroxy vitamin D deficiency or lack of MAU was negatively correlated with serum 25-hydroxy vitamin D, therefore, we should pay attention to the phenomenon of cerebral infarction in patients with 25-hydroxy vitamin D deficiency, to recommend appropriate supplement of vitamin D.