Objective To explore the value of serum vitamin D detection for evaluating recent neurological function recovery in elderly patients with acute ischemic cerebral stroke.Methods A total of 132 patients of acute ischemic stroke in our hospital from March 2013 to January 2015 were selected as the research subjects (the case group).According to the National Institutes of Health Stroke Scale (NIHSS) scores,the patients were divided into mild group (n=56),medium group (n=44) and severe group (n=32).Sixty healthy people with matched age,gender were selected as the control group at the same time.Serum 25-hydroxy vitamin D3 [25-(OH)D3] of the patients were determined on admission.Three months after treatment,the modified Rankin Scale (mRS) was applied to evaluate the prognosis of patients,according to which the patients were divided into well recovery group and poor recovery group.The patients were divided into four groups according to serum 25-(OH)D3 levels:25-(OH)D3>30μg/L group (n=16),20~30μg/L group (n=20),10~20μg/L group (n=67),25-(OH)D3<10μg/L group (n=29).The serum 25-(OH)D3 levels and NIHSS score on admission were compared between groups.Results The serum 25-(OH)D3 levels on admission in the case group were significantly lower than those in the control group (P<0.05),with the levels gradually reduced from mild group to medium group,and severe group.Compared with well recovery group,serum 25-(OH)D3 levels were signif-icantly lower in poor recovery group (P<0.05).In 25-(OH)D3<10μg/L group,the ratio for NIHSS score≥7 and the ratio for poor neurological function recovery were higher than those in 10~20μg/L group,20~30μg/L group,and 25-(OH)D3>30μg/L group,P<0.05.Logistic regression analysis showed that low serum 25-(OH)D3 level was the independent risk factor for poor neurological function recovery in patients with acute ischemic stroke.Conclusion Serum 25-(OH)D3 level is closely related to the degree of disease severity and recent neurological function recovery in elder-ly patients with acute ischemic cerebral stroke.Detection of serum 25-(OH)D3 levels has certain clinical significance for evaluating patient's disease condition and prognosis.%目的 探讨血清维生素D检测对老年急性缺血性脑卒中患者近期神经功能恢复的评估价值.方法 选取2013年3月至2015年1月在我院接受住院治疗的132例急性缺血性脑卒中患者为研究对象(病例组),按照美国国立卫生研究院卒中量表(NIHSS)评分将患者病情分为轻型组(n=56例)、中型组(n=44例)及重型组(n=32例),选取同期60例年龄、性别相匹配的健康体检者为对照组,测定患者入院时的血清25-羟维生素D3 [25-(OH)D3];治疗3个月后采用改良Rankin量表(mRS)对患者预后进行评估,将患者分为神经功能恢复良好组及恢复不良组,以患者血清25-(OH)D3是否充足、不足、缺乏及严重缺乏分为四组:25-(OH)D3>30μg/L组(n=16例)、25-(OH)D3 20~30μg/L组(n=20例)、25-(OH)D3 10~20μg/L组(n=67例)、25-(OH)D3<10μg/L组(n=29例);比较各组的血清25-(OH)D3水平和入院时NIHSS评分的差异.结果 病例组患者入院时的血清25-(OH)D3明显低于对照组,差异有统计学意义(P<0.05),其水平从轻型组到重型组逐渐降低;与神经功能恢复良好组比较,恢复不良组患者血清25-(OH)D3偏低,差异有统计学意义(P<0.05);在血清25-(OH)D3严重缺乏患者中,入院NIHSS评分≥7分、神经功能恢复不良的比例高于25-(OH)D3缺乏组、不足及充足组,差异均有统计学意义(P<0.05);二分类Logistic回归分析显示,低血清25-(OH)D3水平是急性缺血性脑卒中患者近期神经功能恢复不良的独立危险因素.结论 血清25-(OH)D3水平与老年急性缺血性脑卒中患者病情严重程度及近期神经功能恢复程度密切相关,检测老年血25-(OH)D3水平对评估患者病情及预后具有一定的临床意义.
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