血清25-羟维生素D水平与急性脑梗死预后的关系

目的 探讨在急性脑梗死患者中25-羟维生素D25(OH)D]水平与病情预后的关系.方法 入选130例急性脑梗死患者,检测25(OH)D的水平,根据水平分为A组维生素D充足(≥75 nmol/L)、B组不足(50.0~74.9 nmol/L)、C组缺乏(≤49.9 nmol/L).并于入院时及治疗2周后分别测定神经功能受损程度(NIHSS)、日常生活活动(ADL)量表的Barthel指数(BI),根据NIHSS差值判定预后.结果 A、B、C 3组间入院时及治疗2周后NIHSS及BI评分差异均有统计学意义(P＜0.05).A组NIHSS及BI评分明显高于B组、C组.血清25(OH)D水平与患者入院时及治疗2周后的NIHSS评分呈负相关,与患者入院时及治疗2周后BI评分呈正相关.A组的基本痊愈、显著进步、进步例数明显高于B组、C组,两两比较差异有统计学意义.A组、B组无变化、恶化例数明显低于C组,差异有统计学意义.结论 25(OH)D可作为急性脑梗死的危险预测因子,是判断患者病情及预后的客观指标.

Correlations of serum 25-hydroxyvitamin D with disease severity and outcome of acute cerebral infarction

Objective To investigate the correlation between serum serum 25-hydroxyvitamin （D25OH]D） and severity of disease and outcome in acute cerebral infarction. Methods Serum 25（OH）D was measured in 130 acute cerebral infarction patients. According to the different concentration of vitamin D, the patients were divided into A group（sufficient 975 nmol/L）,B group（critical 50.0 74.9 nmol/L）,C group （unsufficient≤49.9 nmol/L）. All of patients were evaluated by National Institutes of Health Stroke Scale（NIHSS） and Barthel index（BI） on admission and two weeks after treatment. The prognosis was judged according to the NIHSS value. Results There were significant difference in NIHSS and BI score among three groups on admission and two weeks after treatment（ P 〈0.05）. NIHSS and BI score of A group were obviously higher than those in B group, C group. Serum 25 （OH） D was negative correlated with NIHSS score, but positive correlated with BI score on admission and two weeks after treatment. The case numbers of basic recovery, significant progress, progress in A group were significantly higher than those in B group and C group. The case numbers of no change, deterioration in A group, B group were significantly lower than those of C group. Conclusion 25 （OH） D is a risk factor for acute cerebral infarction,and it is an objective index to judge severity and prognosis of the disease.