老年HFpEF患者25(OH)D水平及其与心功能、生活质量的关系

Relationship between 25(OH)D level and cardiac function and quality of life in elderly patients with HFpEF

目的 评估老年射血分数保留的心力衰竭(HFpEF)患者25(OH)D水平及其与心功能、生活质量的关系。方法 选取156例65岁以上HFpEF患者与同龄心功能正常老年人对比25(OH)D水平。将HFpEF组按照25(OH)D浓度分为四组,血清25(OH)D<10 Ug/L为A组,10 Ug/L≤25(OH)D<20 Ug/L为B组,20 Ug/L≤25(OH)D≤30 Ug/L为C组,25(OH)D>30 Ug/L为D组。分别对各组进行NYHA心功能评定、6 min步行试验(6MWT)、23项堪萨斯心肌病问卷(KCCQ)。结果 与对照组相比,HFpEF组25(OH)D明显下降,[16.00(12.82,21.81)vs.14.26(11.26,21.07),P<0.05];与对照组相比,HFpEF组25(OH)D不足率明显增多,[90.3%vs.96.2%,P<0.05]。A组NYHA ClassⅠ~Ⅱ级比率较其他各组更低[(52.0%vs.83.0%)、(52.0%vs.81.2%)、(52.0%vs.100%),P均<0.05],A组6MWT较其他各组更低[(260.43±40.62 vs.299.91±71.28)、(260.43±40.62 vs.324.07±40.62)、(260.43±40.62 vs.349.03±60.81),P均<0.05]、A组KCCQ较其他各组更低[(61.13±6.80 vs.66.74±6.84)、(61.13±6.80 vs.70.79±7.31)、(61.13±6.80 vs.72.37±5.78),P均<0.05]。B组与C、D组相比,6MWT更差,但差异无显著性[(299.91±71.28 vs.324.07±40.62)、(299.91±71.28 vs.349.03±60.81),P均>0.05];但B组KCCQ较C组、D组显著降低[(66.74±6.84 vs.70.79±7.31)、(66.74±6.84 vs.72.37±5.78),P均<0.05]。C组、MWT(324.07±40.62 vs.349.03±60.81,P>0.05)、KCCQ(70.79±7.31)D组(6 vs.72.37±5.78,P>0.05)无显著差异。结论 老年HFpEF患者25(OH)D水平低下,过低的25(OH)D水平伴随心功能、生活质量更差。

Objective To evaluate the relationship between 25(OH) D level and cardiac function and quality of life in elderly patients with heart failure with preserved ejection fraction(HFpEF).Methods The 25(OH)D levels of 156 HFpEF patients over 65 years old were compared with those of the same age with normal cardiac function.The HFpEF group was divided into four groups according to the concentration of 25(OH)D.group A with serum 25(OH)D<10 Ug/L,group B with serum 10 Ug/L≤25(OH)D<20 Ug/L,group C with serum 20 Ug/L≤25(OH)D≤30 Ug/L,and group D with serum 25(OH)D>30 Ug/L.NYHA cardiac function assessment,6-minute walking test(6MWT) and Kansas City Cardiomyopathy Questionnaire(KCCQ) were performed in each group.Results Compared with the control group,25(OH)D in the HFpEF group was significantly decreased [16.00(12.82,21.81) vs.14.26(11.26,21.07),P<0.05];Compared with the control group,the 25(OH)D deficiency rate in HFpEF group was significantly increased [90.3% vs.96.2%,P<0.05].The ratio of NYHA ClassⅠ~Ⅱ in group A was lower than that in other groups [(52.0% vs.83.0%),(52.0% vs.81.2%),(52.0% vs.100%),all P<0.05].6MWT in group A was lower than that in other groups [(260.43±40.62 vs.299.91±71.28),(260.43±40.62 vs.324.07±40.62),(260.43±40.62vs.349.03±60.81),all P<0.05].KCCQ in group A was lower than that in other groups [(61.13±6.80 vs.66.74±6.84),(61.13±6.80 vs.70.79±7.31),(61.13±6.80 vs.72.37±5.78),all P<0.05].Compared with groups C and D,6MWT in group B was worse,but the difference was not significant [(299.91±71.28 vs.324.07±40.62),(299.91±71.28 vs.349.03 ±60.81),P>0.05].However,KCCQ in group B was significantly lower than that in groups C and D [(66.74±6.84 vs.70.79±7.31),(66.74±6.84 vs.72.37±5.78),both P<0.05].There were no significant differences in 6MWT(324.07±40.62 vs.349.03±60.81,P>0.05) and KCCQ(70.79±7.31 vs.72.37±5.78,P>0.05) between groups C and D.Conclusion The level of 25(OH)D in elderly patients with HFpEF is low.Too low 25(OH)D level is associated with worse cardiac function and quality of life.