维生素D补充联合规范化二级防治方案对冠心病患者的临床价值

摘要

Objective To analyze the clinical value of vitamin D supplementation combined with standard secondary prevention and treatment in patients with coronary heart disease(CHD).Methods 120 patients with CHD were divided into the control group and the observation group,60 cases in each group.Both groups were given the standard secondary prevention and treatment and the observation group were additionally given vitamin D supplementation.The changes of glucose and lipid metabolism and carotid plaque before and after treatment were compared between the two groups,and the incidence of readmission in the two groups was sta-tistically analyzed.Results After 6 and 12 months of treatment,the fasting blood glucose(FPG),2 h post-prandial blood glucose(2 h PG),carotid intima-media thickness(IM T),coronary plaque integral and high-sen-sitivity C reactive protein(hs-CRP)in the observation group were lower than those in the control group,while glycosylated hemoglobin(HbA1c),serum calcium and 25(OH)D3were higher than those in the control group (P<0.05);There were no significant differences between the two groups in the incidence rates of adverse car-diovascular events and readmission(P>0.05).Conclusion In the treatment of patients with CHD,vitamin D supplementation combined with standard secondary prevention and treatment can regulate glucose and lipid metabolism,delay the progression of carotid atherosclerosis and reduce the incidence of adverse cardiovascular events.%目的 分析维生素D补充联合规范化二级防治方案对冠心病患者的临床价值.方法 将120例冠心病患者分为对照组与观察组,各60例,两组均予规范化二级防治方案,观察组在此基础上加用维生素D补充治疗,比较两组治疗前后糖脂代谢、颈动脉斑块的变化情况,并统计两组再次入院事件的发生情况.结果治疗6、12个月,观察组空腹血糖(FPG)、餐后2 h血糖(2 h PG)、颈动脉内膜-中膜厚度(IM T)、冠脉斑块积分、超敏C反应蛋白(hs-CRP)水平均低于对照组,糖化血红蛋白(HbA1c)、血钙、25羟维生素D3[25(OH)D3]均高于对照组,差异均有统计学意义(P< 0.05);两组不良心血管事件及再入院率比较,差异无统计学意义(P>0.05).结论 在冠心病患者的临床治疗中,采用维生素D补充联合规范化二级防治方案,可调节患者糖脂代谢,延缓颈动脉粥样硬化进展,减少不良心血管事件的发生率.