血清25羟维生素D在非ST段抬高型心肌梗死患者分级中的临床应用

 目的  探究25羟维生素D［25-hydroxy-vitamin D, 25-(OH)D］与血清脂类物质的相关性及其在心肌梗死溶栓治疗临床试验分级(thrombolysis in myocardial infarction, TIMI)中的临床应用。方法  此项研究收集2015年12月至2016年5月在复旦大学附属中山医院急诊部就诊的89例急性非ST段抬高型心肌梗死(non-ST-segment elevation myocardial infarction, NSTEMI)患者和89例接受体检的健康人群。收集178例样本的临床信息以及25-(OH)D和脂类物质的血清学结果, 比较评估心梗患者与正常人群血清25-(OH)D的差异, 使用多重线性回归分析25-(OH)D与血清脂类物质的相关性。采用Logistic回归分析NSTEMI患者各独立参数对于TIMI分级的影响。结果  NSTEMI患者血清25-(OH)D浓度明显低于体检的健康人群。血清25-(OH)D与总胆固醇存在负相关, 而与三酰甘油存在正相关。血清25-(OH)D是TIMI分级的保护因素。结论  25-(OH)D作为TIMI的保护因素, 在评估NSTEMI患者的临床TIMI分级中具有辅助意义。

The clinical application of serum 25-hydroxy-vitamin D in classifying non-ST-segment elevation myocardial infarction patients

Objective  To investigate the correlation between 25-hydroxy-vitamin D ［25-(OH)D］ and serum lipid profile, and its clinical application in thrombolysis in myocardial infarction (TIMI). Methods  From Dec. 2015 to May 2016, 89 non-ST-segment elevation myocardial infarction (NSTEMI) patients in the Department of Emergency, Zhongshan Hospital were enrolled in this study, as well as 89 health people who received physical examination at the same time. The clinical information, the concentration of 25-(OH)D and serum lipid profile of total 178 people were collected. The difference concentration of 25-(OH)D in serum between NSTEMI patients and health people were evaluated. The correlation of 25-(OH)D with serum lipid profile were analyzed by multiple linear regression. Logistic regression analysis was used to identified independent factors of TIMI in the NSTEMI group. Results  The concentration of 25-(OH)D was significantly decreased in the NSTEMI patients compared to the health controls. The 25-(OH)D negatively correlated with total cholesterol, and positively correlated with triglyceride. 25-(OH)D was the independent protective factor of TIMI. Conclusions  As the independent protective factor of TIMI, 25-(OH)D could play a subsidiary role in classifying NSTEMI patients in TIMI.