25(OH)D₃、PTH与心衰严重程度的相关性研究

A Study of the Relationship among 25(OH)D₃, PTH, and Severity of Heart Failure

摘要: 目的：对25(OH)D₃、甲状旁腺激素(PTH)与慢性心力衰竭心衰(CHF)严重程度的相关性进行系统研究。方法：选取住院CHF患者186例，其中HFpEF 96例，HFmrEF 30例，HFrEF 60例；研究同时选取同期健康人群42例作为对照组，收集一般资料、血清25(OH)D₃、PTH、NT-proBNP水平、常规生化指标、心脏彩超结果等，另根据CHF组患者的不同亚型将186例CHF患者分为HFpEF组(96例患者)、HFmrEF组(30例患者)和HFrEF组(60例患者)，对比HFpEF组、HFmrEF组和HFrEF组患者血清25(OH)D₃和PTH表达水平差异，并进行统计分析。结果：CHF组和对照组一般资料和常规生化指标等资料对比差异无统计学意义(P > 0.05)；而CHF组和对照组在25(OH)D₃、PTH以及NT-proBNP等资料对比差异有统计学意义(P < 0.05)。25(OH)D₃表达水平与CHF疾病的发生呈负相关(r = −0.442, P < 0.001)，而PTH表达水平与CHF疾病的发生呈正相关(r = 0.521, P < 0.001)。HFrEF组患者25(OH)D₃表达水平明显低于HFpEF组和HFmrEF组，而PTH表达水平明显高于HFpEF组和HFmrEF组(P < 0.05)，而HFpEF组和HFmrEF组患者血清25-羟基VitD3表达水平无显著差异(P > 0.05)。结论：25‐羟维生素D3和PTH表达水平与心衰严重程度密切相关。25‐羟维生素D3和PTH联合检测对CHF疾病的诊断及病情严重程度评估具有重要的临床意义。

Abstract: Objective: To conduct a systematic study on the correlation among 25(OH)D₃, parathyroid hormone (PTH) and the severity of chronic heart failure (CHF). Methods: One hundred and eighty-six hospitalized CHF patients were selected, of which 96 were HFpEF, 30 were HFmrEF, and 60 were HFrEF; 42 healthy people in the same period of time were also selected as the control group for the study, and general data, serum 25(OH)D₃, PTH, NT-proBNP levels, routine biochemical indexes, and cardiac ultrasound results were collected, and the other 186 patients were divided into HFpEF group (96 patients), HFmrEF group (30 patients), and HFrEF group (60 patients) according to different subtypes of patients in the CHF group, and the differences in the expression levels of serum 25(OH)D₃ and PTH among the patients in HFpEF group, HFmrEF group and HFrEF group were compared and statistically analyzed. Results: There was no statistically significant difference between the general data and routine biochemical indexes of the CHF group and the control group (P > 0.05); while the data of 25(OH)D₃, PTH and NT-proBNP were compared between the CHF group and the control group, there was statistically significant difference (P < 0.05). The expression level of 25(OH)D₃ was negatively correlated with the occurrence of CHF disease (r = −0.442, P < 0.001), and the expression level of PTH was positively correlated with the occurrence of CHF disease (r = 0.521, P < 0.001). Patients in the HFrEF group had a significantly lower level of 25(OH)D₃ expression than those in the HFpEF group and the HFmrEF group, while the level of PTH expression was significantly higher than those in the HFpEF group and the HFmrEF group (P < 0.05), and the patients in the HFpEF group and the HFmrEF group serum 25-hydroxyVitD3 expression levels were not significantly different (P > 0.05). Conclusion: The expression levels of 25-hydroxyvitamin D3 and PTH are closely related to the severity of heart failure. Combined detection of 25-hydroxyvitamin D3 and PTH is clinically important for the diagnosis of CHF disease and assessment of disease severity.