本文選題：充血性心力衰竭 + 血清25-羥基VitD3��； 參考：《青島大學(xué)》2017年碩士論文

【摘要】：目的:探討充血性心力衰竭(CHF)患者血清25-羥基VitD(25-(OH)D3)水平與血清腦鈉肽(BNP)、LVEF的關(guān)系。方法:選擇126例CHF患者,測定其LVEF、血清25-(OH)D3、BNP水平。再依據(jù)NYHA分級標(biāo)準(zhǔn)進(jìn)行分級,比較不同NYHA分級患者LVEF、25-(OH)D3及BNP的水平差異,分析25-(OH)D3與LVEF、BNP的相關(guān)性。且選30例我院查體健康者作為健康對照組,進(jìn)行基線對比及LVEF、25-(OH)D3及BNP水平的比較;對心衰組病人進(jìn)行6個月隨訪,以心臟不良事件再入院進(jìn)行分組進(jìn)行25-(OH)D3水平的比較.結(jié)果:基線比較,心衰組和對照組男女性別比例、年齡、甘油三酯(TG)、總膽固醇(TC)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)水平無顯著差異;與健康對照組比較,心衰組血清中的BNP水平顯著高于正常水平,BNP的水平隨著NYHA分級的逐漸增高而數(shù)值增加,呈正相關(guān)關(guān)系,兩兩比較顯示出各不同分級組間比較均存在統(tǒng)計學(xué)意義(q=8.12~41.61,P0.05)。隨著慢性心力衰竭患者心功能分級的提高,血清25-(OH)D3水平呈現(xiàn)逐漸降低的趨勢,兩兩比較顯示出各不同分級組間比較均存在統(tǒng)計學(xué)意義(q=3.37~14.07,P0.05);與健康對照組比較,心衰組血清中的BNP水平顯著高于正常水平;25-(OH)D3與LVEF低于正常水平(P均0.05);126例CHF患者血清中25-(OH)D3、LVEF水平隨著NYHA分級的增加而降低(P0.01);BNP水平隨著NYHA分級的增加而增高(P0.01)。血漿測BNP濃度與25-(OH)D3呈負(fù)相關(guān)(r=-0.585,P0.01);對心衰患者出院后進(jìn)行為期6個月的隨訪,根據(jù)出現(xiàn)因心臟事件再入院的患者分為未發(fā)生心臟事件和發(fā)生心臟事件再入院率與血清25-(OH)D3水平的關(guān)系進(jìn)行比較,結(jié)果表明:發(fā)生心臟事件組患者血清中的25-(OH)D3水平顯著低于未發(fā)生心臟事件組(P0.01)。在本次研究中,不同的NYHA分級患者25-(OH)D3的水平隨著NYHA分級的增加呈遞減趨勢,觀察組血清25-(OH)D3水平明顯低于對照組,與相關(guān)文獻(xiàn)描述一致。所以我們在臨床上可以得出,檢測25-(OH)D3的水平可以客觀的直接的反應(yīng)出心力衰竭患者心功能的高低好壞,甚至可以作為我們對心衰患者終末期病情的轉(zhuǎn)歸的一種評定標(biāo)準(zhǔn)。結(jié)論:CHF患者心力衰竭嚴(yán)重程度與血清25-(OH)D3水平有關(guān),血清25-(OH)D3水平可以作為其觀察指標(biāo)。
[Abstract]:Objective: to investigate the relationship between serum 25-hydroxyVitD (25-OH) D 3) and serum BNPP LVEF in patients with congestive heart failure (CHF). Methods: LVEF and serum 25-OHH D 3 BNP levels were measured in 126 patients with CHF. Then according to the NYHA classification standard, the differences of LVEF25-OHH3 and BNP levels in patients with different NYHA grading were compared, and the correlation between 25-(OH)D3 and LVEFNP-BNP was analyzed. There was a negative correlation between plasma BNP concentration and 25-(OH)D3. The patients with heart failure were followed up for 6 months after discharge. According to the patients who had readmission due to cardiac events, the relationship between the readmission rate of no cardiac events and the level of serum 25-(OH)D3 was compared. The results showed that the level of 25-(OH)D3 in the patients with cardiac events was significantly lower than that in the patients without cardiac events (P 0.01). Conclusion the severity of heart failure is related to the level of serum 25-(OH)D3, and the level of serum 25-(OH)D3 can be used as an index.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R541.6

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本文編號：1933728