血清维生素D水平与老年急性脑梗死患者预后的关系研究

Relationship between serum vitamin D level and prognosis of elderly patients with acute cerebral infarction

目的研究分析血清维生素D水平与老年急性缺血性脑梗死患者的预后关系。方法对在我院进行治疗的200例老年急性脑梗死患者的血清维生素D水平进行检测,根据血清维生素D水平将入选的200例患者分为极低水平组(50例)、低水平组(50例)、中水平组(50例)和高水平组(50例)四组。之后依据改良mRS评分对患者1年后功能恢复情况进行评估。结果患者的血清维生素D平均值为(47.4±21.7)nmol/L。通过比较极低水平组、低水平组、中水平组和高水平组患者间的一般资料发现,两组患者三酰甘油、血红蛋白、HDL、糖化血红蛋白、1年后mRS评分以及预后情况比较,差异有统计学意义(P均<0.05);而性别、年龄、高血压、糖尿病、冠心病、房颤、脑梗史、吸烟史、白细胞和C反应蛋白等比较,差异无统计学意义(P均>0.05);同时,调整相关因素如性别、年龄、糖尿病、高血压、白细胞、三酰甘油、空腹血糖以及NIHSS评分,采用多元逻辑回归模型分析血清维生素D水平和mRS评分的相关性显示,高水平组1年以后相关功能恢复优良(OR=0.448,95%CI:1.11~3.23),其次是中水平组(OR=0.413,95%CI:1.03~2.74)。结论血清维生素D水平对急性脑梗死患者的功能恢复情况进行独立预测的准确性较高,因此具有较高的临床应用价值。

Objective To study and analyze the relationship between serum vitamin D level and prognosis of elderly patients with acute ischemic cerebral infarction.Methods We tested serum vitamin D levels of 200 elderly patients with acute cerebral infarction treated in our hospital.According to serum vitamin D levels,the 200 patients enrolled were divided into 4 groups:extremely low-level group(50 cases),low level group(50 cases),middle-level group(50 cases)and high-level group(50 cases).The patient’s functional recovery after one year was evaluated based on the modified mRS score.Results The mean serum vitamin D of the patient was(47.4±21.7)nmol/L.By comparing the general data between patients in extremely low-level group,low-level group,middle-level group and high-level group,it was found that there were significant differences in the hemoglobin,glycosylated hemoglobin,triacylglycerol,high density lipoprotein level,mRS score after 1 year and good prognosis rate between the two groups(all P<0.05).The differences in gender,age,hypertension,diabetes,coronary heart disease,atrial fibrillation,history of cerebral infarction,smoking history,white blood cells and C-reactive protein were not significant(all P>0.05).At the same time,after adjusting for interference factors such as age,gender,hypertension,diabetes,atrial fibrillation,white blood cells,hemoglobin,fasting blood glucose,triacylglycerol,and NIHSS scores,multiple logistic regression models were used to analyze the correlation between serum vitamin D levels and mRS scores.The results showed that patients in high-level group recovered well after one year(OR=0.448,95%CI:1.11-3.23),followed by middle-level group(OR=0.413,95%CI:1.03-2.74).Conclusion Serum vitamin D levels show high accuracy for independent prediction of functional recovery in patients with acute cerebral infarction,and therefore have high clinical application value.