高海拔地区腰椎间盘突出人群血清25羟维生素D水平变化及意义

Changes in the serum 25 hydroxyvitamin D levels in patients with lumbar disc herniation at high altitude and the clinical significance

目的 探讨高海拔地区腰椎间盘突出(LDH)人群血清25羟维生素D(25-OH-D)水平变化及临床意义。方法 选取2021年8月至2022年7月我院高海拔地区200例初治LDH患者作为研究组,另选同期、同年龄段100例健康志愿者作为对照组。比较2组一般资料、血清25-OH-D水平,并比较研究组不同临床特征患者血清25-OH-D水平,分析患者血清25-OH-D水平与临床特征的相关性。研究组经治疗3个月后评估疗效,分析初治LDH患者疗效的影响因素,比较不同疗效患者治疗后血清25-OH-D水平,分析治疗后血清25-OH-D水平与疗效的相关性。结果 研究组血清25-OH-D水平低于对照组(P<0.05);研究组血清25-OH-D水平与病情程度、椎间盘退变程度呈负相关(r值分别为了-0.527、-0.584,P<0.05);单因素分析显示,年龄、体重指数、病情程度、椎间盘退变程度、治疗前血清25-OH-D水平与初治LDH患者疗效存在关联性(P<0.05);多因素分析显示,年龄、体重指数、治疗前血清25-OH-D水平是初治LDH患者疗效的影响因素(P<0.05);疗效良好患者治疗1~3个月后血清25-OH-D水平较疗效不良患者高(P<0.05),25-OH-D与疗效呈正相关(r值分别为0.468、0.491、0.523,P<0.05)。结论 高海拔地区LDH人群25-OH-D水平降低,与病情程度、椎间盘退变程度密切相关。

Objective To investigate the changes in serum 25 hydroxyvitamin D(25-OH-D)levels in patients with lumbar disc herniation(LDH)at high altitude and the clinical significance.Methods Two hundred LDH patients at high altitude who were initially treated in our hospital from August 2021 to July 2022 were selected as the study group,and another age-matched 100 healthy volunteers during the same period were selected as the control group.The general data and serum 25-OH-D level of the two groups were compared,and the serum 25-OH-D levels of LDH patients with different clinical characteristics in the study group were compared.The correlation between serum 25-OH-D levels and clinical characteristics in LDH patients was assessed.The efficacy of the study group was evaluated after 3 months of treatment,and the factors influencing the efficacy of patients with primary LDH were analyzed.Post-treatment serum 25-OH-D levels of LDH patients with different efficacies were compared,and the correlation between post-treatment serum 25-OH-D levels and efficacy was analyzed.Results Serum 25-OH-D in the study group was significantly lower than that of the control group(P<0.05).Serum 25-OH-D in the study group was negatively correlated with the severity of the disease and the degree of intervertebral disc degeneration(r=-0.527 and-0.584,respectively;P<0.05).Univariate analysis showed that age,body mass index(BMI),severity of disease,degree of intervertebral disc degeneration,and pre-treatment serum 25-OH-D levels were significantly correlated with the efficacy of patients with primary LDH(P<0.05).Multifactorial analysis showed that age,BMI,and serum 25-OH-D level before treatment were factors influencing the efficacy of patients with primary LDH(P<0.05).Serum 25-OH-D levels after 1 month,2 months,and 3 months of treatment were significantly higher in patients with good efficacy than those with poor efficacy,which were positively correlated with the efficacy(r=0.468,0.491 and 0.523,respectively;P<0.05).Conclusion Serum 25-OH-D levels in LDH populations at high altitudes decrease,which are closely correlated with the severity of disease and intervertebral disc degeneration.