维生素D对终末期肾病患者心血管保护研究进展

Research progress on cardiovascular protective effect of vitamin D in end-stage renal disease patients

慢性肾脏病发病率逐年增高,进展至终末期肾病的患者明显增加,心血管并发症是终末期肾病患者最主要的死因,如何减少终末期肾病患者心血管并发症发生,延缓心血管并发症发展已成为临床医师的当务之急。既往研究证实维生素D缺乏及其信号通路异常是造成患者心血管疾病重要的危险因素之一。维生素D缺乏促进血管内皮损伤及动脉粥样硬化、心室重构、甲状旁腺素过度分泌、心血管微炎症等,导致心血管事件发生。该文将系统阐述终末期肾病患者维生素D缺乏的病理生理机制,维生素D缺乏与心血管结构和功能改变、心血管并发症的关系,从而对预防终末期肾病患者心血管事件发生,改善患者预后有一定临床意义。

The incidence of chronic kidney disease,especially the end-stage renal disease(ESRD),is increasing annually.Cardiovascular complications are the primary causes of the death of ESRD patients.How to decrease the incidence and prevent the progression of cardiovascular complications in ESRD patients has become an urgent task for clinicians.Previous studies have demonstrated that the vitamin D deficiency and abnormal signaling pathway are important risk factors of cardiovascular events in ESRD patients.Vitamin D deficiency can lead to the incidence of cardiovascular events by promoting the endothelial cell injury and atherosclerosis,ventricular remodeling,hyper-secretion of parathormone,cardiovascular micro-inflammatory state,etc.In this review,the pathophysiological mechanism of vitamin D deficiency and the relationship between vitamin D deficiency and cardiovascular anatomical and functional changes and cardiovascular complications in ESRD patients was systematically analyzed,aiming to provide clinical significance for preventing the incidence of cardiovascular events and improving the clinical prognosis of ESRD patients.