血清25羟维生素D与老年冠心病患者衰弱关联的研究进展

Research Progress on the Association between Serum 25-Hydroxyvitamin D and Frailty in Elderly Patients with Coronary Heart Disease

摘要: 衰弱常与心血管疾病尤其是冠心病相互作用且共存，是影响老年冠心病患者不良预后的独立危险因素。血清25羟维生素D在机体中参与免疫调节、骨代谢及血管稳态，其缺乏与老年人群冠心病及衰弱的发生发展密切相关。本文系统检索PubMed、CNKI、万方等数据库2015~2025年相关文献，综述血清25-羟维生素D在老年冠心病合并衰弱患者中的水平变化、潜在作用机制及临床干预研究进展。现有证据表明，血清25羟维生素D缺乏可能通过加重血管损伤、诱发炎症反应等途径促进冠心病患者衰弱发生，补充维生素D可能改善部分患者的衰弱状态，但研究结论仍存在争议。未来需开展大样本、多中心、长期随访的队列研究，明确三者的因果关系及个体化干预策略，为临床防治提供依据。

Abstract: Frailty often interacts with and coexists with cardiovascular diseases, particularly coronary heart disease (CHD), and acts as an independent risk factor for adverse outcomes in elderly patients with CHD. Serum 25-hydroxyvitamin D (25(OH)D) is involved in immune regulation, bone metabolism, and vascular homeostasis in the human body, and its deficiency is closely linked to the development and progression of CHD and frailty in the elderly population. This article systematically searched relevant literature published from 2010 to 2025 in databases including PubMed, CNKI, and Wanfang Data, and reviews the research progress regarding changes in serum 25(OH)D levels, potential mechanisms of action, and clinical interventions in elderly CHD patients complicated with frailty. Existing evidence suggests that serum 25(OH)D deficiency may promote the development of frailty in CHD patients by exacerbating vascular injury and inducing inflammatory responses. Vitamin D supplementation may improve the frailty status of some patients, but research conclusions remain controversial. In the future, large-sample, multi-center, long-term follow-up cohort studies are required to clarify the causal relationship among the three and formulate individualized intervention strategies, thus providing a basis for clinical prevention and treatment.