血清25-羟基维生素D水平与急性缺血性脑卒中严重程度的分析

摘要

目的 探讨血清25-羟基维生素D(25-Hydroxyvitamin D,25(OH)D)水平与急性缺血性脑卒中患者病情严重程度的关系.方法 连续收集2015-05 2015-11于中国医科大学附属盛京医院神经内科住院治疗的急性缺血性脑卒中患者169例,记录人口学特征、危险因素,测定血清25(OH)D水平,入院时完善NIHSS评分.结果 轻型脑卒中组(NIHSS评分＜5分)116例,重型脑卒中组(NIHSS评分≥5分)53例,2组患者血清25(OH)D水平、脑血管病史、空腹血糖、舒张压单因素分析后有明显差异(P＜0.05),多因素分析显示血清25(OH)D水平是缺血性脑卒中严重程度(NIHSS)独立预测因子且为缺血性脑卒中的保护性因素(OR值=0.908,95％ CI:0.859～0.96,P＜0.01);空腹血糖是缺血性脑卒中严重程度独立预测因子且为缺血性脑卒中的危险因素(OR值=1.213,95％ CI:1.019～1.444,P＜0.05);舒张压是缺血性脑卒中严重程度独立预测因子且为缺血性脑卒中的危险因素(OR值=1.037,95％ CI:1.005～1.069,P＜0.05).结论 血清25(OH)D、空腹血糖、舒张压是急性缺血性脑卒中严重程度的独立预测因子,且25(OH)D是保护性因素,空腹血糖和舒张压是危险因素.%Objective To discuss the correlation between serum25-hydroxyvitamin D (25 (OH) D) levels and the severity of the patients with acute ischemic stroke.Methods 169 patients with acute ischemic stroke were continuously assessed from the Department of Neurology,the Affiliated Sheng Jing Hospital of China Medical University.Demographic data and history of risk factors were obtained at admission.The determination of serum 25 (OH) D levels were measured and the NIHSS was improved at admission.Results Light Stroke Group (NIHSS score＜5 min) has 116 cases,heavy stroke group (NIHSS score≥5points) has 53 cases,two groups had significant differences in serum 25 (OH) d level,cerebrovascular history,fasting glucose and diastolic blood pressure (P＜0.05),the multifactor analysis revealed that serum 25 (OH) d level was an independent predictor in ischemic stroke (by assessing NIHSS) and 25 (OH) d was a protective factor in ischemic stroke (or value =0.908,95％) CI:0.859-0.96,P＜0.01,fasting blood glucose and diastolic pressure were independent predictors of ischemic stroke and the risk factors for ischemic stroke,fasting blood glucose (or value=1.213,95 ％ CI:1.019～ 1.444,P＜0.05),diastolic pressure (or value=1.037,95 ％ CI:1.005～1.069,P＜0.05).Conclusion Serum 25 (OH) d,fasting blood glucose,diastolic pressure are independent predictors of severity of acute ischemic stroke,and 25 (OH) d is a protective factor,fasting blood glucose and diastolic pressure are the risk factors.