血清25-羟维生素D水平可预测缺血性中风患者的梗死体积和死亡率。

Serum levels of 25-hydroxyvitamin D predicts infarct volume and mortality in ischemic stroke patients.

作者信息

Nie Zhong, Ji Xiao-Chun, Wang Jian, Zhang Hong-Xing

机构信息

Department of Radiology,The First Affiliated Hospital and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China.

EEG Room,The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China.

出版信息

J Neuroimmunol. 2017 Dec 15;313:41-45. doi: 10.1016/j.jneuroim.2017.10.002. Epub 2017 Oct 5.

DOI:10.1016/j.jneuroim.2017.10.002

PMID:29153607

Abstract

BACKGROUND

The aim of this study is to determine 25-hydroxyvitamin D [25(OH) D] levels in serum, and investigate their associations with cardiovascular disease (CVD) or all-cause mortality in a 1-year follow-up study in patients with first-ever ischemic stroke.

METHODS

From November 2013 to October 2015, 387 consecutive patients with ischemic stroke admitted to our hospital were identified. Serum 25(OH) D levels were measured at admission. Infarct volume was measured using diffusion-weighted imaging (DWI). The primary end point was CVD mortality among 1year. The secondary end point was all-cause mortality.

RESULTS

In this study, 387 patients were included. A statistically significant negative correlation between serum 25(OH) D level and infarct volume was found (r=-0.442; P<0.001). There were 74 patients (19.1%, 95%CI: 15.2%-23.0%) died, including 36 CVD mortality (9.3%, 95CI%: 6.4%-12.2%). The mortality distribution across the 25(OH) D quartiles ranged between 39.2% (first quartile) to 5.2% (fourth quartile) for all-cause mortality and between 18.6% (first quartile) to 2.1% (fourth quartile) for CVD mortality. In a multivariate model using the first quartiles of 25(OH) D vs. quartiles 2 through 4 together with the clinical variables, the marker displayed prognostic information CVD mortality: OR for first quartile, 3.06 [95% CI, 2.16-4.95]; all-cause mortality: OR for first quartile, 2.76 [95% CI, 2.01-4.32].

CONCLUSIONS

The data show serum levels of 25(OH) D at admission is useful prognostic marker of CVD and all-cause mortality in Chinese patients with ischemic stroke.

摘要

背景

本研究旨在测定首次发生缺血性卒中患者血清中25-羟维生素D[25(OH)D]水平，并在为期1年的随访研究中调查其与心血管疾病（CVD）或全因死亡率的关联。

方法

2013年11月至2015年10月，确定了我院连续收治的387例缺血性卒中患者。入院时测定血清25(OH)D水平。使用弥散加权成像（DWI）测量梗死体积。主要终点是1年内的CVD死亡率。次要终点是全因死亡率。

结果

本研究纳入了387例患者。发现血清25(OH)D水平与梗死体积之间存在统计学显著的负相关（r=-0.442；P<0.001）。有74例患者（19.1%，95%CI：15.2%-23.0%）死亡，其中36例死于CVD（9.3%，95CI%：6.4%-12.2%）。全因死亡率在25(OH)D四分位数间的分布范围为39.2%（第一四分位数）至5.2%（第四四分位数），CVD死亡率为18.6%（第一四分位数）至2.1%（第四四分位数）。在一个多变量模型中，将25(OH)D的第一四分位数与第二至第四四分位数以及临床变量一起分析，该标志物显示出CVD死亡率的预后信息：第一四分位数的OR为3.06[95%CI，2.16-4.95]；全因死亡率：第一四分位数的OR为2.76[95%CI，2.01-4.32]。