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目的探讨血清25羟维生素D3[(25-hydroxyvitamin D3,25(OH)D3)]与冠状动脉狭窄程度的相关性。方法 416例疑似冠心病或冠心病患者,均行冠状动脉造影检查,采用ELISA法检测血清25(OH)D3水平,将所有患者血清25(OH)D3水平按四分位数分为4组,分别为Q1组、Q2组、Q3组和Q4组,比较4组一般资料和Gensini积分;根据冠状动脉是否狭窄分为狭窄组和未狭窄组,比较2组血清25(OH)D3水平,分析血清25(OH)D3水平与冠状动脉狭窄程度的相关性。结果冠状动脉狭窄组血清25(OH)D3水平[(10.64±7.82)μg/L]低于对照组[(12.40±8.77)μg/L],差异有统计学意义(P<0.05);Q1组、Q2组、Q3组Gensini积分(6.09±1.32、6.59±1.66、4.30±1.23)高于Q4组(0.93±0.32)(P<0.05);25(OH)D3与C反应蛋白水平(r=-0.141,P=0.004)和Gensini评分(r=-0.150,P=0.002)呈负相关;多因素logistic回归分析结果显示,年龄、C反应蛋白、吸烟是冠状动脉狭窄的相关危险因素(OR=1.056,95%CI:1.034~1.079,P=0.000;OR=1.262,95%CI:1.139~1.398,P=0.000;OR=1.036,95%CI:1.016~1.056,P=0.000);25(OH)D3是冠状动脉狭窄的独立保护因素(OR=0.951,95%CI:0.920~0.983,P=0.003)。结论低水平25(OH)D3与冠状动脉狭窄程度相关。
Objective To investigate the relationship between the serum 25-hydroxyvitamin D3 (25 (OH) D3) and the degree of coronary artery stenosis. Methods 416 cases of suspected coronary heart disease or coronary heart disease patients underwent coronary angiography. Serum 25 (OH) D3 levels were measured by ELISA. All patients’ serum 25 (OH) D3 levels were divided into 4 groups according to quartiles. The patients were divided into two groups: Q1 group, Q2 group, Q3 group and Q4 group. The general data and Gensini scores of four groups were compared. According to whether coronary artery stenosis was divided into stenosis group and stenosis group, serum 25 Correlation between 25 (OH) D3 levels and coronary artery stenosis. Results The level of serum 25 (OH) D3 in coronary artery stenosis group was significantly lower than that in control group [(12.40 ± 8.77) μg / L vs (10.64 ± 7.82) μg / L vs (P <0.05). The Gensini score of Q2 group and Q3 group was significantly higher than that of Q4 group (6.09 ± 1.32, 6.59 ± 1.66, 4.30 ± 1.23, 0.141, P = 0.004) and Gensini score (r = -0.150, P = 0.002) .Multivariate logistic regression analysis showed that age, C-reactive protein and smoking were the risk factors of coronary artery stenosis (OR = 1.056 (95% CI: 1.034 to 1.079, P = 0.000; OR = 1.262, 95% CI: 1.139-1.398; P = 0.000; OR = 1.036, 95% CI: 1.016-1.0556; D3 is an independent protective factor of coronary artery stenosis (OR = 0.951, 95% CI: 0.920-0.983, P = 0.003). Conclusion The low level of 25 (OH) D3 is related to the degree of coronary artery stenosis.