维生素D水平与PCI术后病人早期24 h动态血压变化的相关性研究

卫琪

doi:10.13898/j.cnki.issn.1000-2200.2019.12.009

维生素D水平与PCI术后病人早期24 h动态血压变化的相关性研究

卫琪

Study on the correlation between vitamin D level and early 24-hour ambulatory blood pressure changes in patients after PCI

WEI Qi

摘要

摘要:
目的探讨维生素D水平与经皮冠状动脉介入治疗（PCI）术后病人早期24 h动态血各指标变化的相关性。
方法回顾性分析经PCI治疗的急性心肌梗死住院病人的临床资料。在病人入院时测量25-羟维生素D25（OH）D。使用美国DMS-ABP型动态血压监测仪监测入院时、术后1周及术后4周的24 h动态血压各指标。
结果26例病人25（OH）D正常，21例病人25（OH）D不足，33例病人25（OH）D缺乏。白细胞计数水平为缺乏组病人高于其余2组病人（P < 0.05），CRP水平为正常组病人低于其他两组（P < 0.05）。对入院时、术后1周及术后4周的24 h动态血压组内比较显示，3组病人的24 h平均舒张压（24hDBP）、白昼平均收缩压（dSBP）、白昼平均舒张压（dDBP）、夜间舒张压（nDBP）4个指标在3个时间点的24 h动态血压差异均无统计学意义（P>0.05），正常组除上述4个指标外24hSBP在3个时间点差异也无统计学意义（P>0.05），3组病人的其余各指标在3个时间点的24h动态血压差异均有统计学意义（P < 0.05~P < 0.01）；组间比较显示，25（OH）D缺乏组病人各时间点的24 h动态血压各指标均高于25（OH）D正常组病人（P < 0.05）。入院时25（OH）D水平与入院时、术后1周、术后4周的24 h动态血压指标均呈现负相关（P < 0.05~P < 0.01）。
结论维生素D与PCI术后24 h动态血压各指标变化具有相关性。入院时常规补充维生素D可能有利于PCI术后血压调节，维持24 h动态血压平衡。

Abstract:
ObjectiveTo investigate the correlation between vitamin D level and early 24-hour dynamic blood parameters in patients after percutaneous coronary intervention(PCI).
MethodsThe clinical data of inpatients with acute myocardial infarction treated with PCI were collected.The level of 25-hydroxyvitamin D25(OH) D was measured at admission.The 24-hour ambulatory blood pressure indicators at admission, and after 1 week and 4 weeks of operation were monitored using the American DMS-ABP ambulatory blood pressure monitor.
ResultsThe normal, insufficient and deficiency levels of 25(OH) D in 26, 21 and 33 patients were identified, respectively.The level of WBC in deficiency group was higher than that in other two groups(P < 0.05), and the level of CRP in normal group was lower than that in other two groups(P < 0.05).The differences of the 24-hour ambulatory blood pressure indictors, which included 24-hour average diastolic blood pressure(24hDBP), daytime average systolic blood pressure(dSBP), daytime average diastolic blood pressure(dDBP) and nighttime diastolic blood pressure(nDBP) in three groups at admission, and after 1 week and 4 weeks of operation were not statistically significant (P>0.05).In addition to the above four indicators, the difference of the 24hSBP in normal group at three time-points was not statistically significant(P>0.05), and the differences of other indictors of the 24-hour ambulatory blood pressure in three groups at three time-points were statistically significant(P < 0.05 to P < 0.01).The results of comparisons between groups showed that the 24-hour ambulatory blood pressure indictors in 25(OH) D deficiency group at each time-point were higher than those in 25(OH) D normal group(P < 0.05).The level of 25(OH) D was negatively correlated with the 24-hour ambulatory blood pressure at admission, and after 1 week and 4 weeks of operation(P < 0.05 to P < 0.01).
ConclusionsThe level of vitamin D is correlated with the changes of 24-hours ambulatory blood pressure after PCI.Therefore, the routine vitamin D supplementation at admission may be beneficial to regulate the blood pressure after PCI, and maintain the 24-hour ambulatory blood pressure balance.

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