摘要
目的:探讨冠心病患者血清维生素D[由25-羟基维生素D(325(OH)D3)评估]水平与冠状动脉侧支循环的关系。方法:根据冠状动脉造影结果入选至少有一个主要冠状动脉有慢性闭塞病变的冠心病患者171例。按Rentrop分级法进行冠状动脉侧支循环分级,根据冠状动脉侧支循环发展程度,将患者分为两组:冠状动脉侧支循环不良组(n=81)和冠状动脉侧支循环良好组(n=90)。采用电化学发光免疫分析法测定25(OH)D3水平。结果:与冠状动脉侧支循环良好组相比,冠状动脉侧支循环不良组患者的25(OH)D3水平较低,脂蛋白(a)[LP(a)]水平较高,他汀类药物、血管紧张素转换酶抑制剂(ACEI)/血管紧张素Ⅱ受体拮抗剂(ARB)的使用率均较低(P均<0.05)。随着Rentrop分级的增加,25(OH)D3水平显著升高(P=0.025)。多因素Logistic回归分析显示血清25(OH)D3水平是侧支循环良好的独立预测因子(OR=1.099,95%CI:1.004~1.204;P=0.040)。经倾向评分配比后,25(OH)D3仍是侧支循环良好的独立预测因子(OR=1.137,95%CI:1.007~1.285;P=0.039)。结论:对于冠状动脉慢性闭塞的冠心病患者,血清25(OH)D3水平升高与冠状动脉侧支循环的形成有关,提示25(OH)D3可能对促进冠状动脉侧支循环的形成有潜在的作用。
Objectives:To investigate the relation between serum vitamin D levels(assessed by 25-hydroxyvitamin D3[25(OH)D3])level and coronary collateral circulation(CCC)in patients with coronary chronic total occlusion.Methods:A total of 171 patients with coronary total occlusion were included in this study.CCC severities were graded according to the Rentrop classification.The serum 25(OH)D3 was measured with a electrochemiluminescence immunoassay method.According to the degree of CCC,patients were divided into two groups:patients with poorly developed CCC(n=81),and patients with well-developed CCC(n=90).The serum 25(OH)D3 levels between the two groups were analyzed and compared.Results:Patients in well-developed CCC group were more likely to have higher 25(OH)D3 levels,lower lipoprotein(a)levels,and to be treated with angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers and statins.The mean 25(OH)D3 level increased in proportion to the Rentrop grades(P=0.025).Multivariate logistic regression showed that serum 25(OH)D3 level(OR=1.099,95%CI:1.004-1.204;P=0.040)was an independent predictor of well-developed CCC.After propensity score matching,serum 25(OH)D3 level(OR=1.137,95%CI:1.007-1.285;P=0.039)remained as an independent predictor of well-developed CCC.Conclusions:HIgher 25(OH)D3 levels are associated with well-developed CCC.This finding suggests that 25(OH)D3 might play a potential role on promoting the development of CCC.
作者
孙昊
卢长林
郭宗生
刘佳梅
张媛
王欣
陈牧雷
SUN Hao;LU Changlin;GUO Zongsheng;LIU Jiamei;ZHANG Yuan;WANG Xin;CHEN Mulei(Heart Center,Beijing Chao-yang Hospital,Capital Medical University,Beijing(100020),China)
出处
《中国循环杂志》
CSCD
北大核心
2021年第9期863-867,共5页
Chinese Circulation Journal
基金
北京市重点实验室高血压病研究课题(2019GXY-KFKT-01)。
