PTH、1,25-(OH)2D3在慢性心力衰竭患者中的表达及其意义

Expression and Significance of PTH,1,25-(OH)2D3 in Patients with Chronic Heart Failure

【目的】探讨(CHF)血清甲状旁腺激素(PTH)及1,25-二羟基维生素D3[1,25-(OH)2D3]在慢性心力衰竭(CHF)患者中的表达及其意义。【方法】123例CHF患者根据心功能分级分为Ⅰ~Ⅱ级及Ⅲ~Ⅳ级两组,比较患者血清PTH及1,25-(OH)2D3水平,分析其与心功能分级的关系及诊断分级的效能。【结果】心功能Ⅲ~Ⅳ级患者血清PTH水平明显高于,1,25-(OH)2D3水平明显低于Ⅰ~Ⅱ级患者(P<0.05);PTH及1,25-(OH)2D3两者联合评估心功能分级的效能高于任一单独指标;单因素分析显示年龄≥60岁、高血压、脑卒中、心功能Ⅲ~Ⅳ级、血肌酐、胆固醇、LDL-C、PTH、HDL-C及1,25-(OH)2D3与CHF患者预后存在关联,多因素分析显示心功能Ⅲ~Ⅳ级、高PTH、低HDL-C及1,25-(OH)2D3为影响CHF患者预后不良的独立危险因素;PTH与心功能分级呈正相关,HDL-C及1,25-(OH)2D3与心功能分级呈负相关;PTH与1,25-(OH)2D3呈负相关,而HDL-C与1,25-(OH)2D3呈正相关(r=0.682,P<0.05)。【结论】PTH、1,25-(OH)2D3与CHF患者心功能分级相关且为影响患者预后不良的危险因素。

【Objective】To investigate the expression and significance of serum parathyroid hormone (PTH) and 1,25-dihydroxyvitamin D3 [1,25-(OH)2D3] in patients with chronic heart failure (CHF).【Methods】One hundred and twenty-three patients with CHF were divided into two groups according to cardiac function grading:Ⅰ~Ⅱ and Ⅲ~Ⅳ.The levels of PTH and 1,25-(OH)2D3 in serum were compared,and the relationship between PTH and cardiac function grading and the effectiveness of diagnostic grading were analyzed.【Results】The level of serum PTH in patients with grade III-IV cardiac function was significantly higher than that in patients with grade Ⅲ~Ⅳ cardiac function,and the level of 1,25-(OH)2D3 was significantly lower than that in patients with grade I-II cardiac function (P<0.05);the combined evaluation of PTH and 1,25-(OH)2D3 cardiac function was more effective than any single index;univariate analysis showed that age (>60 years old),hypertension,stroke,cardiac function grade Ⅲ~Ⅳ,serum creatinine,and serum creatinine were higher than any single index Cholesterol,LDL-C,PTH,HDL-C and 1,25-(OH)2D3 were associated with the prognosis of C HF patients.with 1,25-(OH)2D3,and HDL-C was positively correlated with 1,25-(OH)2D3 (P<0.05).Multivariate analysis showed that grade Ⅲ~Ⅳ,high PTH,low HDL-C and 1,25-(OH)2D3 were independent risk factors for poor prognosis of CHF patients;PTH was positively correlated with grade of cardiac function,HDL-C and 1,25-(OH)2D3 were negatively correlated with grade of cardiac function;PTH was negatively correlated with 1,25-(OH)2D3,while HDL-C was positively correlated with 1,25-(OH)2D3 (r=0.682,P<0.05).Conclusion PTH,1,25-(OH)2D3 were correlated with cardiac function grading in CHF patients and are risk factors for poor prognosis.【Conclusion】PTH,1,25-(OH)2D3 are associated with cardiac function grading in CHF patients and are risk factors for poor prognosis.