冠心病患者25羟维生素D、内皮素水平与冠状动脉病变程度的关系

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摘要目的研究冠心病患者25羟维生素D[25（OH）D]、内皮素（ET）水平与冠状动脉病变程度的关系。方法选取2017年9月～2018年8月广东省第二人民医院（以下简称“我院”）收治的冠心病患者200例作为冠心病组，按照Gensini评分不同分成轻度病变组（89例）、中度病变组（66例）、重度病变组（45例），另取同期于我院接受体检的正常人员60名作为正常对照组。比较冠心病组与正常对照组的一般资料情况，检测四组人员的血清25（OH）D及血浆ET水平，并进行相关性及多因素Logistic回归分析。结果冠心病组的总胆固醇、三酰甘油和低密度脂蛋白胆固醇水平均高于正常对照组，差异有统计学意义（P ＜ 0.05）。轻度病变组、中度病变组、重度病变组血清25（OH）D水平低于正常对照组，中度病变组、重度病变组血清25（OH）D水平低于轻度病变组，重度病变组血清25（OH）D水平低于中度病变组（P ＜ 0.05）；轻度病变组、中度病变组、重度病变组血浆ET水平高于正常对照组，中度病变组、重度病变组血浆ET水平高于轻度病变组，重度病变组血浆ET水平高于中度病变组（P ＜ 0.05）。经Pearson相关性分析可得，冠心病患者血清25（OH）D水平与Gensini评分呈负相关（r = -0.597，P ＜ 0.05），而ET水平与Gensini评分呈正相关（r = 0.644，P ＜ 0.05）。经多因素Logistic回归分析可得，25（OH）D是冠心病的保护性因素（OR = 0.735，95%CI：0.608～0.889，P ＜ 0.05），而ET是冠心病的独立危险因素（OR = 2.498，95%CI：1.338～4.663，P ＜ 0.05）。结论冠心病患者血清25（OH）D水平降低、ET水平升高，与冠状动脉病变程度密切相关，是冠心病的影响因素，有望成为临床新的诊断指标。

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	陈武奇谢佳佳杨瑶琳

关键词 ：冠心病, 冠状动脉病变程度, 25羟维生素D, 内皮素

Abstract：Objective To study the relationship between the level of 25 hydroxy vitamin D [25(OH)D] and endothelin (ET) and the severity of coronary artery disease in patients with coronary heart disease (CHD). Methods From September 2017 to August 2018, 200 patients with CHD admitted to the Second People′s Hospital of Guangdong Province (hereinafter referred to as "our hospital") were selected as CHD group, which was divided into 89 patients of mild lesion group, 66 patients of moderate lesion group and 45 patients of severe lesion group according to Gensini score. Another 60 normal persons who received physical examination in our hospital in the same period were taken as normal control group. General data between CHD group and normal control group was compared. The levels of serum 25(OH)D and plasma ET in four groups were measured, and the correlation and multivariate Logistic regression analysis were carried out. Results The levels of total cholesterol, triglyceride and low-density lipoprotein cholesterol in CHD group were higher than those in normal control group, the difference was statistically significant (P < 0.05). Serum levels of 25(OH)D in the mild, moderate and severe lesions groups were lower than those in normal control group, the serum levels of 25(OH)D in moderate and severe lesions groups were lower than those in mild lesion group, and the serum level of 25(OH)D in severe lesion group was lower than that in moderate lesion group (P < 0.05). Serum levels of ET in mild, moderate and severe lesions groups were higher than those in normal control group, serum levels of ET in moderate and severe lesions groups were higher than those in mild lesion group, and serum level of ET in severe lesion group was higher than that in moderate lesion group (P < 0.05). Pearson correlation analysis showed that serum 25(OH)D level was negatively correlated with Gensini score (r = -0.597, P < 0.05), while ET level was positively correlated with Gensini score (r = 0.644, P < 0.05). Multivariate Logistic regression analysis showed that 25(OH)D was the protective factor of CHD (OR = 0.735, 95%CI: 0.608-0.889, P < 0.05), while ET was the independent risk factor of CHD (OR = 2.498, 95%CI: 1.338-4.663, P < 0.05). Conclusion The decrease of serum 25(OH)D level and the increase of ET level in patients with CHD are closely related to the severity of coronary artery disease. They are risk factors of CHD and are expected to become new clinical diagnostic indicators.

Key words： Coronary heart disease Severity of coronary artery disease 25 hydroxy vitamin D Endothelin

基金资助:国家自然科学基金资助项目（81401426）。

引用本文:

陈武奇谢佳佳杨瑶琳. 冠心病患者25羟维生素D、内皮素水平与冠状动脉病变程度的关系[J]. 中国医药导报, 2019, 16(32): 67-70.
CHEN Wuqi XIE Jiajia YANG Yaolin. The relationship between the levels of 25 hydroxy vitamin D and endothelin and the degree of coronary artery disease in patients with coronary heart disease. 中国医药导报, 2019, 16(32): 67-70.

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