Serum 25-hydroxyvitamin D Level in Assessing Prognosis of Patients with Ischemic Stroke
BI Qing-guo, DI Yong, ZHA Wu-hao, et al
Department of Emergency Critical Care Medicine,Zhoupu Hospital of Shanghai Pudong New Area (Zhoupu Hospital Affiliated to Shanghai Medical College),Shanghai 201318
Abstract：【Objective】 To investigate the value of serum fat-soluble vitamin (25-hydroxyvitamin D,25-OH-VD) in evaluating the prognosis of patients with ischemic stroke. 【Methods】 The data of 1000 cases of ischemic stroke admitted to two hospitals were analyzed retrospectively. According to the survival conditions,the patients were divided into the good and the bad prognosis groups,with 510 and 490 cases in each group,respectively. Basic data of the two groups [age,sex,body mass index (BMI),smoking history,infarct size,blood sugar,body temperature,NIHSS score,blood pressure,25-OH-VD] were compared. The predictive value of 25-OH-VD was drawn by ROC curve and analyze the risk factors of poor prognosis of ischemic stroke was analyzed by logistic regression.【Results】 The proportion of patients with infarct size ≥1.5 cm2,hyperglycemia,elevated body temperature,NIHSS score ≥21 and hypertension in the poor prognosis group was significantly higher than that in the good prognosis group,while 25-OH-VD was significantly lower than that in the good prognosis group (P<0.05).By ROC analysis,the area under the curve of 25-OH-VD was 0.680,the optimal cut-off value was 24.500,the sensitivity was 0.450,and the specificity was 0.700,all of which were (P<0.05).Logistic regression analysis showed that infarct size ≥1.5 cm2,hyperglycemia,elevated body temperature,NIHSS score ≥21,hypertension and 25-OH-VD < 24.500 ng/mL were risk factors for poor prognosis in patients with ischemic stroke (P<0.05).【Conclusion】 There are many risk factors affecting the poor prognosis of patients with ischemic stroke,such as infarct size≥1.5 cm2,hyperglycemia,elevated body temperature,NIHSS score≥21 points,hypertension and 25-OH-VD. Of which,25-OH-VD<24.500 ng/mL is the best cutoff value for patients with ischemic stroke and it has a certain reference value in the process of preventing patients with ischemic stroke.
毕庆国, 狄勇, 查吴浩, 刘春兰. 血清25-羟基维生素D水平评估缺血性脑卒中患者预后的价值[J]. 医学临床研究, 2023, 40(3): 414-417.
BI Qing-guo, DI Yong, ZHA Wu-hao, et al. Serum 25-hydroxyvitamin D Level in Assessing Prognosis of Patients with Ischemic Stroke. JOURNAL OF CLINICAL RESEARCH, 2023, 40(3): 414-417.
[1] MACMAHON S,PETO R,CUTLER J,et al. Blood pressure,stroke,and coronary heart disease. part 1,prolonged differences in blood pressure:prospective observational studies corrected for the regression dilution bias[J].Lancet,2015,335(8692):765-774. [2] SIVAN-HOFFMANN R,GORY B,ARMOIRY X,et al. Stent-retriever thrombectomy for acute anterior ischemic stroke with tandem occlusion:a systematic review and meta-analysis[J].Eur Radiol,2017,27(1):247-254. [3] 张文静,高玲玲,任蕾,等. 维生素D与急性缺血性脑卒中发生风险和严重程度的相关性分析[J].国际免疫学杂志,2019,42(4):353-357. [4] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组. 中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(4):246-257. [5] PEZZELLA F R,PICCONI O,DE L A,et al. Development of the Italian version of the national institutes of health stroke scale:It-NIHSS[J].Stroke,2009,40(7):2557-2559. [6] 中华医学会糖尿病学分会. 中国高血糖危象诊断与治疗指南[J].中国糖尿病杂志,2013,5(8):449-461. [7] 胡大一,刘梅林,郭艺芳. 老年高血压的诊断与治疗中国专家共识(2011版)[J].中华内科杂志,2012,4(1):31-39. [8] 王心颖,丁文婷,鲍双振,等. 远隔缺血后适应治疗对缺血性脑卒中患者神经功能保护作用的临床研究[J].中国全科医学,2018,21(18):28-31. [9] 吴钢,许映雪,胡志坚,等. 后循环脑梗死的相关危险因素及可能影响预后因素分析[J].中华神经医学杂志,2015,14(1):37-42. [10] 王凯,魏秀娥,荣良群,等. 伴脑微出血的急性缺血性脑卒中患者预后不良的影响因素分析[J].中华神经医学杂志,2018,17(11):1104-1110. [11] 陆敏智.缺血性脑卒中患者近期功能预后影响因素分析[J].中华物理医学与康复杂志,2018,40(1):38-40. [12] 许晓敬,韩凝,贾阳娟,等. 急性缺血性脑卒中3个月预后相关影响因素[J].河北医科大学学报,2015,36(9):996. [13] 方厚盈,唐伯儒,郭阳. 血清25-羟基维生素D水平与急性缺血性脑卒中短期预后的关系[J].临床与病理杂志,2017,37(11):2389-2394. [14] 张梅,张长庚,姜玉荣,等.sdLDL-C、IMA、25-OH-VD与急性缺血性脑卒中的相关性研究[J].中国免疫学杂志,2020,36(16):2007-2011.
2023, Vol. 40 
