老年非瓣膜性房颤患者血清25羟基维生素D_3水平与血栓栓塞事件及CHA2DS2-VASc评分的关系研究

Research on Correlation between the Serum 25-hydroxyvitamin D_3 and Thromboembolic Events and CHA2DS2-VASc Score of Senile Patients with Non-valvular Atrial Fibrillation

目的探讨血清25羟基维生素D_3(25-hydroxyvitamin D_3,25-OH-Vit D_3)水平与老年非瓣膜性房颤患者发生血栓栓塞事件风险及CHA2DS2-VASc评分的关系。方法方便选取2015年7月—2017年12月该院收治的124例老年瓣膜性房颤患者作为研究对象,其中34例患者出现血栓栓塞事件作为血栓组,90例未出现血栓栓塞事件作为房颤组,以同期医院收治的年龄相匹配的窦性心律者81例为对照组。每例患者进行CHA2DS2-VASc评分,通过超声心动图检查左室舒张末期内径(Left ventricular end-diastolic dimension,LVEDD)、左房内径(Left atrial dimension,LAD)及左室射血分数(Left ventricular ejection fraction,LVEF)通过电化学发光法检测每例患者血清25-OH-Vit D_3水平。比较3组患者血清25-OH-Vit D_3水平,及与LVEDD、LAD、LVEF和CHA2DS2-VASc评分的关系。结果单独房颤组和房颤合并血栓栓塞组血清25-OH-Vit D_3水平明显低于对照组[(31.66±5.44)nmol/L vs(34.40±7.07)nmol/L(t=4.027,P<0.05);(28.16±6.44)nmol/L vs(34.40±7.07)nmol/L(t=6.860,P<0.01)]。与单独房颤组比较,房颤合并血栓栓塞组血清25-OH-Vit D_3水平进一步下降[(28.16±6.44)nmol/L vs(31.66±5.44)nmol/L(t=3.900)],比较差异有统计学意义(P<0.05)。Spearman相关分析显示血清25-OH-Vit D_3水平与CHA2DS2-VASc评分呈负相关(r=-0.327,P<0.01)。Pearson相关分析发现血清25-OH-Vit D_3水平与LAD呈负相关(r=-0.197,P<0.05)。结论血清25羟基维生素D_3水平与老年非瓣膜性房颤患者发生血栓栓塞风险及CHA2DS2-VASc评分有关。

Objective To study the correlation between the serum 25-hydroxyvitamin D3 and thromboembolic events and CHA2 DS2-VASc score of senile patients with non-valvular atrial fibrillation. Methods 124 cases of senile patients with valvular atrial fibrillation admitted and treated in our hospital from July 2015 to December 2017 were conveniently selected as the research objects, 34 cases of patients with thromboembolism events were used as the thromboembolism group, and 90 cases of patients without thromboembolism events were used as the fibrillation group, and 81 cases of age-matched sinus rhythm patients admitted and treated in our hospital at the same period were selected as the control group, and each patient was for CHA2 DS2-VASc marking, and the LVEDD, LAD and LVEF of patients were examined by the echocardiogram, and the serum 25-OH-Vit D3 level of each patient was tested by the electrochemiluminescence, and the serum 25-OH-Vit D3 level and correlation with LVEDD,LAD, LVEF, CHA2 DS2-VASc scores were compared between the three groups. Results The serum 25-OH-Vit D3 level in the simple fibrillation group and the fibrillation and thromboembolism group were obviously lower than those in the control group [（31.66 ±5.44）nmol/L vs（34.40 ±7.07）nmol/L（t =4.027,P 0.05）;（28.16 ±6.44）nmol/L vs（34.40 ±7.07）nmol/L（t =6.860,P 0.01）], and the serum 25-OH-Vit D3 level in the combined group further decreased compared with that in the simple fibrillation group, [（28.16±6.44）nmol/L vs（31.66±5.44）nmol/L（t=3.900）], and the difference between groups was statistically significant（P0.05）, and the Spearman related analysis showed that the serum 25-OH-Vit D3 level was negatively correlated with the CHA2 DS2-VASc score（r=-0.327, P0.01）, and the Pearson related analysis showed that the serum 25-OHVit D3 level was negatively correlated with LAD（r=-0.197, P0.05）. Conclusion The serum 25-hydroxyvitamin D3 are related to the occurrence risk of thromboembolismof senile patients with non-valvular atrial fibrillation and CHA2 DS2-VASc score.