老年患者血清25羟维生素D3与冠状动脉狭窄程度的相关性研究

目的探讨血清25羟维生素D3与老年患者冠状动脉狭窄程度相关性。方法对269例老年患者行冠状动脉造影术,分为狭窄组114例和正常组155例,应用Gensini积分判断冠状动脉狭窄程度。测定血清25羟维生素D3水平,按照25羟维生素D3四分位数分为:Q1组(<15.0nmol/L)60例,Q2组(15.0~22.1nmol/L)74例,Q3组(22.2~35.6nmol/L)68例,Q4组(>35.6nmol/L)67例。结果狭窄组与正常组25羟维生素D3比较,差异有统计学意义[(25.05±16.08)nmol/L vs(31.83±22.36)nmol/L,P=0.004];Q1组、Q2组、Q3组与Q4组Gensini积分比较,差异有统计学意义(P<0.05,P<0.01)。血清25羟维生素D3与C反应蛋白呈负相关(r=-0.548,P=0.000),与Gensini评分呈负相关(r=-0.183,P=0.003)。多元logistic回归分析显示,血清25羟维生素D3是老年患者冠状动脉狭窄独立保护因素(P<0.01)。结论低水平25羟维生素D3与老年患者冠状动脉狭窄程度相关,需进一步研究证实补充25羟维生素D3是否会减少老年冠心病的发病。

Association between serum 25-hydroxy vitamin D3 level and coronary artery stenosis in elderly patients

Objective To study the assoiation between serum 25 hydroxy vitamin[25(OH)D3]level and coronary artery stenosis in elderly patients.Methods Two hundred and sixty-nine elderly patients who underwent coronary angiography were divided into stenosis group(n=114)and control group(n=155).Their serum [25(OH)D3]level was measured and coronary stenosis was assessed according to their Gensini score.The patients were further divided into Q1<15nmol/L group(n=60),Q2:15-22.125nmol/L group(n=74),Q3:22.126-35.6nmol/L group(n=68),and Q4>35.6nmol/L group(n=67).Results The serum [25(OH)D3]level was significantly higher in stenosis group than in control group(P=0.004).The Gensini score was significantly higher in Q1,Q2,and Q3 groups than in Q4group(P<0.05)and decreased with the increasing serum [25(OH)D3]level(r=-0.183,P=0.003).The serum [25(OH)D3]level was negatively related with the CRP level(r=-0.548,P =0.000)and the Gensini score(r=-0.183,P=0.003).Multivariate logistic regression analysis showed that serum [25(OH)D3]level was an independent protective factor for coronary artery stenosis in elderly patients(P<0.01).Conclusion Low serum [25(OH)D3]level is related with coronary artery stenosis in elderly patients.Further study is thus needed to determine whether[25(OH)D3]can reduce the incidence of coronary heart disease in elderly patients.