摘要
目的探讨补充维生素D对伴有维生素D缺乏的青年急性缺血性卒中患者转归的影响。
方法采取前瞻性对照研究方法，连续选取青年急性缺血性卒中患者，维生素D缺乏定义为25-羟基维生素D[25-hydroxyvitamin D, 25（OH）D]≤50 nmol/L。按照随机数字表法将伴有维生素D缺乏的患者分为干预组和常规治疗组，常规治疗组不予针对维生素D缺乏的药物干预，干预组给予每日口服阿法骨化醇0.5 μg。治疗1年后再次复查25（OH）D水平，监测用药期间不良反应，并采用改良Rankin量表评估功能转归，0～2分定义为转归良好。
结果在176例青年急性缺血性卒中患者中，94例（53.41%）伴有维生素D缺乏者被随机分为干预组和常规治疗组，每组各47例。随访结束时，干预组转归良好率（82.98%对63.83%；χ2＝4.414，P＝0.036）和血清25（OH）D水平[（85.83±10.53）nmol/L对（39.10±11.18）nmol/L；t＝20.860，P〈0.001]均显著高于常规治疗组。随访期间，2组均无失访和死亡事件，干预组仅见2例恶心，1例头昏，不良反应发生率为6.38%。
结论补充维生素D可提高伴有维生素D缺乏的青年急性缺血性卒中患者的维生素D水平，改善功能转归。
ObjectiveTo investigate the effect of vitamin D supplementation on the outcome of acute ischemic stroke in young patients with vitamin D deficiency.MethodsThe prospective controlled study was used to select the consecutive young patients with acute ischemic stroke. Vitamin D deficiency was defined as 25-hydroxyvitamin D （25（OH）D） ≤50 nmol/L. The Patients with vitamin D deficiency were randomly divided into an intervention group and a routine treatment group according to the random number table method. Routine treatment group didn＇t receive the drug intervention for vitamin D deficiency, and the intervention group received daily oral alfacalcidol 0.5 μg. After 1 year of treatment, the 25（OH）D levels were examined again; the adverse reactions during the drug treatment were monitored; the modified Rankin Scale （mRS） was used to evaluate the functional outcome and 0-2 was defined as good outcome.ResultsThere are 94 patients （53.41%） with vitamin D deficiency among 176 young patients with acute ischemic stroke. They were randomly divided into either an intervention group or a routine treatment group （n=47 in each group）. At the end of the follow-up, the good outcome rate （82.98% vs. 63.83%; χ2=4.414, P=0.036） and serum 25（OH）D level （85.83±10.53 nmol/L vs. 39.10±11.18 nmol/L; t=20.860, P〈0.001） in the intervention group were significantly higher than those in the routine treatment group. During the follow-up period, there was no loss to follow-up or death events in both groups. Only 2 cases of nausea and 1 case of dizziness were observed, and the incidence of adverse reaction was 6.38% in the intervention group.ConclusionsVitamin D supplement can increase the vitamin D levels and improve functional outcome in young patients with acute ischemic stroke and vitamin D deficiency.
作者
王凯
荣良群
魏秀娥
陶中海
肖利杰
Wang Kai Rong Liangqun Wei Xiu＇e Tao Zhonghai Xiao Lijie(Department of Neurology, the Second Affiliated Hospital of Xuzhou Medical University, Xuzhou 221006, China)
出处
《国际脑血管病杂志》
2017年第6期506-510,共5页
International Journal of Cerebrovascular Diseases
基金
徐州矿务集团有限公司科技项目（2014-59）
关键词
卒中
脑缺血
年轻人
维生素D
维生素D缺乏
治疗结果
Stroke
Brain Ischemia
Young Adult
Vitamin D
Vitamin D Deficiency
Treatment Outcome
