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25(OH)D3、PTH与心衰严重程度的相关性研究
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Abstract:
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。
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
| [1] | Heidenreich, P.A., Bozkurt, B., Aguilar, D., et al. (2022) 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Journal of the American College of Cardiology, 79, 1757-1780. https://doi.org/10.1016/j.jacc.2021.12.011 |
| [2] | 夏勇, 张建卿, 王少霞, 等. 沙库巴曲缬沙坦联合琥珀酸美托洛尔缓释片治疗冠状动脉粥样硬化性心脏病并慢性心力衰竭的效果观察[J]. 首都医科大学学报, 2020, 41(1): 113-118. |
| [3] | Greene, S.J., Bauersachs, J., Brugts, J.J., et al. (2023) Worsening Heart Failure: Nomenclature, Epidemiology, and Future Directions: JACC Review Topic of the Week. Journal of the American College of Cardiology, 81, 413-424. https://doi.org/10.1016/j.jacc.2022.11.023 |
| [4] | Gruson, D., Buglioni, A. and Burnett, J.J. (2014) PTH: Potential Role in Management of Heart Failure. Clinica Chimica Acta, 433, 290-296. https://doi.org/10.1016/j.cca.2014.03.029 |
| [5] | Bischoff-Ferrari, H.A., Giovannucci, E., Willett, W.C., et al. (2006) Estimation of Optimal Serum Concentrations of 25-Hydroxyvitamin D for Multiple Health Outcomes. The American Journal of Clinical Nutrition, 84, 18-28. https://doi.org/10.1093/ajcn/84.1.18 |
| [6] | 顾驾云, 夏海莲, 王芳芳, 等. 慢性心力衰竭患者检测外周血甲状旁腺激素的临床研究[J]. 中华危重症医学杂志: 电子版, 2016, 9(6): 394-397. |
| [7] | German, N., Popov, A., Ramanaviciene, A., et al. (2019) Enzymatic Formation of Polyaniline, Polypyrrole, and Polythiophene Nanoparticles with Embedded Glucose Oxidase. Nanomaterials (Basel), 9, 806. https://doi.org/10.3390/nano9050806 |
| [8] | 高杰, 冯妍, 王以新, 等. 不同程度心力衰竭合并贫血患者的病因及合并疾病特点分析[J]. 中国医药, 2022, 17(10): 1451-1454. |
| [9] | Borlaug, B.A. (2020) Evaluation and Management of Heart Failure with Preserved Ejection Fraction. Nature Reviews Cardiology, 17, 559-573. https://doi.org/10.1038/s41569-020-0363-2 |
| [10] | 毛承誉, 朱华芳, 张田田, 等. 上海市社区中老年人群心力衰竭患病率流行病学调查研究[J]. 中国预防医学杂志, 2019, 20(2): 124-127. |
| [11] | 彭钰, 李捷, 周铭, 等. 超声不同扫描技术在慢性心力衰竭患者左心室功能评估中的应用[J]. 中国医师杂志, 2021, 23(4): 579-582. |
| [12] | McDonagh, T.A., Metra, M., Adamo, M., et al. (2022) 2021 ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure: Developed by the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure of the European Society of Cardiology (ESC) with the Special Contribution of the Heart Failure Association (HFA) of the ESC. Revista Espa？ola de Cardiología (English Edition), 75, 523. https://doi.org/10.1016/j.rec.2022.05.005 |
| [13] | 于炎武, 蒲博轩, 赫广达, 等. 高敏感格拉斯哥评分与射血分数保留型心力衰竭患者长期预后的关联性分析[J]. 临床心血管病杂志, 2024, 40(1): 64-68. |
| [14] | 田水, 巫廷春, 田龙海, 等. 血清25-羟维生素D3水平与STEMI患者直接PCI术后恶性心律失常相关性研究[J]. 心脑血管病防治, 2021, 21(4): 353-356. |
| [15] | 马雷, 姚丛月, 缪博, 等. 社区获得性肺炎患儿血清25-羟维生素D3、总IgE表达及其与疾病严重程度相关性[J]. 国际呼吸杂志, 2022, 42(22): 1707-1712. |
| [16] | Khan, A.A., Rubin, M.R., Schwarz, P., et al. (2023) Efficacy and Safety of Parathyroid Hormone Replacement with TransCon PTH in Hypoparathyroidism: 26-Week Results from the Phase 3 PaTHway Trial. Journal of Bone and Mineral Research, 38, 14-25. https://doi.org/10.1002/jbmr.4726 |
| [17] | Eastman, K., Gerlach, M., Piec, I., et al. (2021) Effectiveness of Parathyroid Hormone (PTH) Analogues on Fracture Healing: A Meta-Analysis. Osteoporosis International, 32, 1531-1546. https://doi.org/10.1007/s00198-021-05847-0 |
| [18] | Chen, L., Xiong, L., Yao, L., et al. (2023) Attenuation of Alzheimer’s Brain Pathology in 5XFAD Mice by PTH1-34, a Peptide of Parathyroid Hormone. Alzheimer’s Research & Therapy, 15, Article No. 53. https://doi.org/10.1186/s13195-023-01202-z |
| [19] | 曾福强, 瞿国萍, 邹斌, 等. 超声引导下射频消融治疗继发性甲状旁腺功能亢进对血清PTH、血钙、磷浓度的影响[J]. 医学影像学杂志, 2020, 30(1): 39-42 72. |
