發(fā)布時(shí)間：2018-04-21 22:28

  本文選題：維生素D + 2型糖尿病��； 參考：《青島大學(xué)》2015年碩士論文

【摘要】：目的調(diào)查青島地區(qū)老年住院患者的維生素D缺乏現(xiàn)狀;探討在老年2型糖尿病患者中,維生素D與心血管發(fā)病率及危險(xiǎn)因素間的關(guān)系。方法收集2014年11月至2015年4月在青島大學(xué)附屬醫(yī)院住院并檢測(cè)血清25-羥維生素D(25(OH)D)的60歲以上老年患者1821例,通過(guò)查閱病歷收集臨床診斷、年齡、性別等基本資料,根據(jù)年齡、25(OH)D、臨床診斷等指標(biāo)將患者分組比較,利用SPSS19統(tǒng)計(jì)學(xué)軟件分析各組間25(OH)D差異性;篩選上述患者中符合入組標(biāo)準(zhǔn)的2型糖尿病患者94例,收集一般情況、疾病史、實(shí)驗(yàn)室指標(biāo)等。根據(jù)合并疾病狀況、糖尿病病程及血清25(OH)D水平將患者分組。應(yīng)用多元Logistic回歸分析心血管病變與危險(xiǎn)因素的關(guān)系,應(yīng)用pearson分析25(OH)D與各危險(xiǎn)因素的相關(guān)性。結(jié)果在1821例老年患者中,不同性別組間,男性組VD缺乏率為88.75%,女性組缺乏率為87.87%,血清25(OH)D含量男性組低于女性組,但差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.3670.05);不同年齡組間比較,高齡組(≥75歲)血清25(OH)D含量低于低齡組(60-74歲),其結(jié)果具有顯著性差異(p=0.0060.01);不同疾病組間血清25(OH)D含量差異具有統(tǒng)計(jì)學(xué)意義(p=0.0440.05),其中腎病組25(OH)D最低(39.89±23.66nmol/L),高血壓組25(OH)D最高(60.69±28.27nmol/L)。在上述94例糖尿病患者中,合并心血管疾病組較糖尿病組在25(OH)D、總膽固醇(TC)、血尿酸(UA)、血鈣(Ca)水平上比較均有統(tǒng)計(jì)學(xué)差異(p0.05)。不同病程組間25(OH)D隨病程逐漸增長(zhǎng)呈現(xiàn)遞減趨勢(shì)。在pearson相關(guān)性分析中,25(OH)D與年齡、纖維蛋白原(FIB)、TC、UA呈負(fù)相關(guān),與D-二聚體、高密度脂蛋白(HDL-C)呈正相關(guān),其中與FIB、TC呈顯著相關(guān)(p0.01);在Logistic回歸分析中,以心血管疾病是否發(fā)病作為因變量,以25(OH)D與其他心血管危險(xiǎn)因素作為自變量,結(jié)果顯示25(OH)D缺乏組的心血管發(fā)生風(fēng)險(xiǎn)為1.17倍(OR 1.17,p=0.0350.05)�！窘Y(jié)論】1.本研究為首例對(duì)青島地區(qū)老年住院患者維生素D缺乏情況調(diào)查,發(fā)現(xiàn)青島老年住院患者維生素D缺乏現(xiàn)象嚴(yán)重,其缺乏率為88.41%;老年男性及75歲以上高齡人群缺乏率分別為88.75%、89.19%。2.老年2型糖尿病患者中血清25(OH)D水平與年齡、FIB、TC、UA、D-二聚體、HDL-C等心血管危險(xiǎn)因素具有相關(guān)性。3.維生素D缺乏是老年2型糖尿病患者心血管疾病發(fā)病的獨(dú)立危險(xiǎn)因素。
[Abstract]:Objective to investigate the status of vitamin D deficiency in elderly inpatients in Qingdao, and to explore the relationship between vitamin D and cardiovascular morbidity and risk factors in elderly patients with type 2 diabetes. Methods from November 2014 to April 2015, 1821 elderly patients over 60 years old who were hospitalized in the affiliated Hospital of Qingdao University and detected the serum 25-hydroxyvitamin D (25-hydroxyvitamin D) were collected and collected the basic data of clinical diagnosis, age, sex and so on. The patients were divided into two groups according to their age and clinical diagnosis. The differences of 25(OH)D among the groups were analyzed by SPSS19 software, 94 patients with type 2 diabetes who met the criteria of entering the group were selected, and the general situation and disease history were collected. Laboratory indicators, etc. The patients were divided into groups according to the condition of the complicated disease, the course of diabetes and the level of serum 25(OH)D. Multivariate Logistic regression analysis was used to analyze the relationship between cardiovascular disease and risk factors, and pearson was used to analyze the correlation between 25(OH)D and risk factors. Results among 1821 elderly patients, the VD deficiency rate of male group was 88.755.The deficiency rate of female group was 87.87.The serum 25(OH)D content in male group was lower than that in female group, but there was no significant difference between male group and female group. The serum 25(OH)D level in the elderly group (鈮，

本文編號(hào)：1784365