文章摘要
翁峰标,张建伟,凡进,李青青,余利鹏,殷国勇.脊柱外科手术患者术前维生素D含量的临床分析[J].南京医科大学学报,2015,(12):1727~1730
脊柱外科手术患者术前维生素D含量的临床分析
A clinical analysis of vitamin D status in patients before spinal surgery
投稿时间:2015-05-17  
DOI:10.7655/NYDXBNS20151212
中文关键词: 维生素D缺乏  维生素D不足  脊柱手术
英文关键词: vitamin D deficiency  vitamin D insufficiency  spinal surgery
基金项目:国家自然科学基金资助(81271988)
作者单位
翁峰标 南京医科大学第一附属医院骨科,江苏 南京 210029
吴江市第一人民医院骨科,江苏 苏州 215000 
张建伟 南京医科大学第一附属医院骨科,江苏 南京 210029 
凡进 南京医科大学第一附属医院骨科,江苏 南京 210029 
李青青 南京医科大学第一附属医院骨科,江苏 南京 210029 
余利鹏 南京医科大学第一附属医院骨科,江苏 南京 210029 
殷国勇 南京医科大学第一附属医院骨科,江苏 南京 210029 
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中文摘要:
      目的:研究脊柱外科手术患者术前维生素D的浓度,分析缺乏维生素D的相关危险因素。方法:回顾性分析503例手术患者,术前均常规测定血清25羟基维生素D[25(OH)D]的浓度,以25(OH)D≥32 ng/mL评定为患者血清维生素D的含量正常,25(OH)D≥20 ng/mL且﹤32 ng/mL为维生素D含量不足,﹤20 ng/mL为维生素D含量缺乏。结果:503例脊柱外科手术患者中,维生素D缺乏及不足的比率分别为71.4%和23.9%,女性患者维生素D缺乏的比例较男性患者高(P < 0.001);BMI增大(P=0.009)和吸烟(P﹤0.001)患者维生素D缺乏的比例更高;月份分析中,维生素D缺乏比例最低为9月份(44.8%),最高为1月份(90.6%);季度分析中,患者维生素D含量冬季最低,秋季最高(P=0.001);年龄?骨密度与维生素D的含量无显著相关性。多因素分析结果表明,女性(P < 0.001)?吸烟(P=0.005)?冬季(P=0.001)是维生素D缺乏的潜在危险因素。结论:脊柱外科手术患者术前存在严重的维生素D不足和缺乏,可能影响患者的手术预后,需要加强对脊柱外科患者术前维生素D含量的筛查和治疗。
英文摘要:
      Objective:To study preoperative concentrations of vitamin D in patients undergoing spinal surgery and analyze relevant risk factors associated with vitamin D deficiency. Methods:A retrospective analysis was conducted on 503 patients undergoing spinal surgery. Preoperative concentrations of serum 25-hydroxyvitamin D[25(OH)D]were measured. Normal vitamin D was defined as a serum 25(OH)D level ≥ 32 ng/mL,vitamin D insufficiency as 25(OH)D ≥ 20 and <32 ng/mL,and vitamin D deficiency as 25(OH)D < 20 ng/mL. Results:The rate of vitamin D deficiency and insufficiency was 71.4% and 23.9%,respectively. Rate of vitamin D deficiency in female patients was significantly higher than that in male patients (P < 0.001). Rate of vitamin D deficiency in patients with high body mass index (P = 0.009)or patients with smoking habit (P < 0.001)was much higher compared with that in the other patients. An analysis of monthly vitamin D levels revealed that rate of vitamin D deficiency was the lowest in September(44.8%),and the highest in January(90.6%). The analysis of quarterly vitamin D levels showed that rate of vitamin D deficiency was the lowest in winter and the highest in fall (P = 0.001). No correlation between vitamin D status with age or bone mineral density was identified. Multivariate analysis demonstrated that female(P < 0.001),smoking(P = 0.005),and winter(P = 0.001)were potential risk factors for vitamin D deficiency. Conclusion:Severe preoperative vitamin D insufficiency and deficiency existed in spinal surgery patients,and vitamin D insufficiency or deficiency may largely affect surgical outcomes of patients. Therefore,screening of preoperative vitamin D status and relevant treatment should be reinforced in spine surgery patients.
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