中国血液净化

中国血液净化 ›› 2021, Vol. 20 ›› Issue (06): 382-386.doi: 10.3969/j.issn.1671-4091.2021.06.006

• 临床研究 • 上一篇    下一篇

维生素D水平与血液透析患者心脏功能的相关性研究

谢蕾1,韩恩红1,梁付桂1,汪艳2,陈树荣1,高建军1   

  1. 1中国人民解放军战略支援部队特色医学中心肾脏病科 2中国人民解放军北京卫戍区朝阳第一退休干部休养所卫生所内科
  • 收稿日期:2021-01-28 修回日期:2021-03-25 出版日期:2021-06-12 发布日期:2021-06-17
  • 通讯作者: 高建军 gao306kidney@126.com E-mail:gao306kidney@126.com

Correlation between vitamin D level and cardiac function in hemodialysis patients 

  1. 1Department of Nephrology, Chinese PLA Strategic Support Force Medical Center, Beijing 100101, China;  2Internal Medicine Department, Chaoyang First Sanitarium for Retired Cadres of Beijing Garrison of PLA, Beijing 100026, China
  • Received:2021-01-28 Revised:2021-03-25 Online:2021-06-12 Published:2021-06-17

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摘要： 【摘要】目的调查研究血液透析患者血清25-羟维生素D[25 hydroxyvitamin D,25(OH)D]水平与其心血管功能的关系。方法采用横断面调查研究方法，收集战略支援部队特色医学中心血液净化中心109名血液透析患者血清标本测定血清25(OH)D水平、临床指标及心脏彩超结果，应用相关分析及多元回归分析血清25(OH)D水平与心脏功能相关性。结果患者血清25(OH)D平均值为(50.39± 22.74) nmol/L，其中低血清25(OH)D 者(≤50 nmol/L)共有65 人，占59.6%。正常25(OH)D 患者与低25(OH)D 患者比较，二尖瓣口E 峰与二尖瓣环E 峰血流速度比值(e/e’)有明显差异(t=2.425,P=0.001)。Spearman 分析显示25(OH)D 与e/e´呈负相关(r=- 0.272,P=0.004)。多元回归分析显示25(OH)D 为e/e´的独立相关因素(β =-0.115,95%CI:-0.129～-0.009，P=0.010)。结论维持性血液透析患者普遍血清25(OH)D 水平偏低，血清25(OH)D水平与左心室舒张功能独立相关。

关键词: 血清25-羟维生素D, 血液透析, 心脏舒张功能

Abstract: 【Abstract】Objective To investigate the relationship between serum 25-hydroxyvitamin D (25(OH)D) level and cardiovascular function in hemodialysis patients. Methods This was a cross-sectional study. Serum 25(OH)D levels were determined from 109 hemodialysis patients treated in the Dialysis Center of the PLA Strategic Support Force Medical Center. Clinical data and cardiac ultrasound results of the 109 hemodialysis patients were collected. Correlation and multivariate regression analyses were used to evaluate the relationship between serum 25(OH)D level and cardiovascular function. Results The average value of 25(OH)D was
50.39±22.74 nmol/L in the hemodialysis patients, in which 65 patients (59.6%) were identified as 25(OH)D deficient (≤50nmol/L). By comparing between 25(OH)D normal group and 25(OH)D deficient group, there were no significant differences in B-type natriuretic peptide (BNP), high- sensitivity C-reactive protein (hs-CRP), intact parathyroid hormone (iPTH), hemoglobin, left ventricular mass (LVM), left ventricular mass index (LVMI), ejection fraction (EF), fraction shortening (FS), left ventricular internal dimensions at end-diastole (LVIDd), posterior wall thickness at end- diastole (PWTd), septal wall thickness at end- diastole (SWTd), left ventricular end diastolic diameter (LVED), systolic left ventricular volume (LVES) and the ratio of mitralwave E peak velocity to A peak velocity (e/a), but there was a significant difference in the ratio mitral-wave E peak velocity to mitral annulus velocity E’(e/e ́) (t=2.495, P=0.001). Spearman analysis showed that 25(OH) D was negatively correlated with e/e ́ (r=-0.272, P=0.004). Multivariate regression showed that 25(OH)D was an independent correlation factor for e/e´(β=-0.115, 95% CI: -0.129～-0.009, P=0.010). Conclusions Serum 25(OH)D level was lower in maintenance hemodialysis patients. 25(OH)D level was independently and negatively correlated with left ventricular diastolic function.

Key words: Serum 25-hydroxyvitamin D, Hemodialysis, Cardiac diastolic function

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