心力衰竭患儿血清25-(OH)D3水平及与心功能参数的关系研究

The study on the relationship between serum 25-(OH)D3 level and the parameters of heart function in children with heart failure

目的:探讨心力衰竭患儿25-羟维生素D3[25-(OH)D3]水平及与心功能参数的关系。方法:选取四川省凉山州第一人民医院儿科2016年1月至2019年12月收治的心血管疾病患儿278例,按照改良Ross分级评分分为心力衰竭组84例(观察组),无心力衰竭组194例(对照组);检测血清25-(OH)D3、脑钠肽(BNP)及超声心动图检测血流动力学指标,包括左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、左室舒张末期容量(LVEDV)和左心室质量(LVM),经体表面积标化推算左室舒张末期内径指数(LVEDDI)和左室舒张末期容量指数(LVEDVI);以LVM/身高^2.7( g/m^2.7)计算左心室质量指数(LVMI)。结果:与对照组比较,观察组血清25-(OH)D3水平显著降低(P<0.01);观察组25-(OH)D3不足或缺乏发生率较对照组显著升高(P<0.01);观察组BNP水平、LVEDDI、LVEDVI和LVMI较对照组显著升高(均P<0.01)。血清25-(OH)D3水平与BNP(r=-0.82,P<0.01)、LVEDDI(r=-0.703,P=0.015)、LVEDVI(r=-0.119,P=0.018)和LVMI(r=-0.714,P=0.017)呈负相关关系。结论:心力衰竭患儿血清25-(OH)D3水平降低,与BNP、LVEDDI、LVEDVI和LVMI呈负相关关系。

Objective:To investigate the relationship between 25-(OH)D3 level and the parameters of heart function in children with heart failure(HF).Methods:A total of 278 children with cardiovascular disease who were admitted to the Department of Pediatrics,Liangshanzhou First People's Hospital from January 2016 to December 2019 were enrolled.According to the modified Ross classification score,they were divided into a HF group with 84 cases(observation group)and a non-heart failure(Non-HF)group with 194 cases(control group).Serum 25-(OH)D3 and brain natriuretic peptide(BNP)were detected.The echocardiography was used to detect hemodynamic parameters,including left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),left ventricular end diastolic volume(LVEDV),and left ventricular mass(LVM).The left ventricular end diastolic diameter index(LVEDDI)and the left ventricular end diastolic volume index(LVEDVI)were calculated by body surface area standardization.Left ventricular mass index(LVMI)was calculated by LVM/height^2.7(g/m^2.7).Results:Compared with the control group,serum 25-(OH)D3 level was significantly reduced in the observation group(P<0.01).The incidence of 25-(OH)D3 insufficiency or deficiency in observation group was significantly increased when compared to the control group(P<0.01).BNP level,LVEDDI,LVEDVI,and LVMI were significantly increased in the observation group when compared with the control group(P<0.01).Serum 25-(OH)D3 level was negatively correlated to BNP(r=-0.82,P<0.01),LVEDDI(r=-0.703,P=0.015),LVEDVI(r=-0.119,P=0.018),and LVMI(r=-0.714,P=0.017).Conclusion:The serum 25-(OH)D3 level in children with HF was significantly decreased,which were negatively associated with BNP,LVEDDI,LVEDVI,and LVMI.