血清25羟基维生素D水平与慢性再生障碍性贫血患者再住院的相关性

The correlation between serum 25 hydroxyvitamin D levels and readmission in patients with chronic aplastic anemia

目的探讨血清25羟基维生素D[25(OH)D]水平与慢性再生障碍性贫血(AA)患者再住院的相关性。方法选择2020年1月至2022年12月在安徽医科大学附属阜阳人民医院住院治疗的105例慢性AA患者。采用化学发光法测定血清25(OH)D水平,依据平均值将其分为低值组和高值组。比较两组患者的临床资料差异,采用logistic多因素分析影响慢性AA患者再入院的危险因素,使用Kaplan-Meier法绘制曲线比较两组再入院率和再次住院间隔时间的差异。结果低值组(<19.39 ng/ml)和高值组(≥19.39 ng/ml)患者的再次住院间隔时间比较差异有统计学意义[(2.61±1.03)个月vs(3.27±1.32)个月,P<0.05]。较高水平的血清25(OH)D是降低慢性AA患者再入院风险(OR:0.739;95%CI:0.569~0.962)和延长再次住院间隔时间(Log Rank=0.004,Breslow=0.01,Tarone-Ware=0.005;P<0.05)的保护因素,较长的病程时间是再入院的危险因素(OR=3.432,P=0.006)。低值组患者累计应用维生素D补充剂≥3周,其再次住院间隔时间显著延长(P<0.001)。结论血清25(OH)D水平的异常降低会缩短慢性AA患者再次住院间隔时间和增加再入院的风险。

Objective To explore the correlation between serum 25 hydroxyvitamin D[25(OH)D]levels and readmission in patients with chronic aplastic anemia(AA).Methods A total of 105 patients with chronic AA who were hospitalized at the Fuyang People′s Hospital Affiliated to Anhui Medical University from January 2020 to December 2022 were selected.The serum 25(OH)D level was measured using chemiluminescence method,and it was divided into low value group and high value group based on the average value.We compared the clinical data differences between two groups of patients,used logistic multivariate analysis to identify the risk factors for readmission in chronic AA patients,and used the Kaplan Meier method to plot curves to compare the differences in readmission rates and readmission intervals between the two groups.Results The difference in the interval between readmission between patients in the low value group(<19.39 ng/ml)and those in the high value group(≥19.39 ng/ml)was statistically significant[(2.61±1.03)months vs(3.27±1.32)months,P<0.05].A higher level of serum 25(OH)D was a protective factor in reducing the risk of readmission(OR:0.739;95%CI:0.569-0.962)and prolonging the interval between readmission(Log Rank=0.004,Breslow=0.01,Tarone-Ware=0.005;P<0.05)in chronic patients,while long course of illness was a risk factor for readmission(OR=3.432,P=0.006).Patients in the low value group who had accumulated the use of vitamin D supplements for≥3 weeks had a significantly longer interval between readmission(P<0.001).Conclusions Abnormal reduction of serum 25(OH)D levels can shorten the interval between readmission and increase the risk of readmission in chronic AA patients.