Expression Of Serum Vitamin D And Myocardial Vitamin D Receptors In Children With Congenital Heart Disease And Its Clinical Significance

objectiveTo investigate the levels and clinical significance of serum vitamin D and myocardial vitamin D receptor in children with Congenital heart disease CHD(hereinafter referred to as Congenital heart disease),so as to provide evidence for the prevention and treatment of Congenital heartdisease in childrenMethodA total of 70 children with congenital heart disease diagnosed by color doppler ultrasound and requiring surgical treatment in the department of cardiothoracic surgery of hainan women and children's medical center from December 2018 to January 2020 were randomly selected as the experimental group and divided into a simple atrial septal defect group,a simple ventricular septal defect group and a composite group.Meanwhile,70 normal children of the same age who underwent physical examination in the department of child health of our hospital were randomly selected as the control group.The serum levels of 25-hydroxyvitamin D and brain natriuretic peptide were determined by roche electrochemical luminescence method.In addition,19 cases of congenital heart disease were randomly selected from 70 cases of congenital heart disease.Atrial septal defect group received atrial muscle specimens,ventricular septal defect group received ventricular muscle specimens,and composite group received atrial muscle and ventricular muscle specimens,and the expression of VDR in atrial and ventricular muscles was detected by IHCResult1.Compared with the control group,25 hydroxy vitamin D deficiency was significant in the experimental group(P<0.05).There was no significant difference in serum levels of 25 hydroxy vitamin D between the two groups(P>0.05,P>0.05)2.There was no significant difference in the level of 25 hydroxyvitamin D between the experimental group and the control group(x2=0.826,P>0.05)3.The level of 25 hydroxyvitamin D in the experimental group was significantly lower and the level of brain natriuretic peptide was significantly increased(P<0.05,P<0.05).There was no significant difference in 25-hydroxyvitamin D between men and women before and4.after surgery,and the difference was not statistically significant(P>0.05,P>0.05)4.There was no significant difference in 25-hydroxyvitamin D and left ventricular ejection fraction between the three groups(P>0.05,P>0.05).There was no significant difference in brain natriuretic peptide(asymptotic significance=0.47)5.There was no linear correlation between 25-hydroxyvitamin D and left ventricular ejection fraction and defect size(P>0.05 and P>0.05).It was negatively correlated with brain natriuretic peptide,and the difference was statistically significant(P<0.05)6.There was no significant difference in the expression of vitamin D receptor in atrial and ventricular muscles,and the difference was not statistically significant(P>0.05).Moreover,there was no difference in the expression of vitamin D receptor between simplex congenital heart disease and complex congenital heart disease,and the difference was not statistically significant(P>0.05)7.There was no significant difference in the expression of atrial and ventricular vitamin D receptors in children with congenital heart disease(P>0.05,P>0.05).Correlation analysis revealed ventricular muscle vitamin D receptor expression and preoperative and postoperative 25 hydroxy vitamin D there are negative correlation,(r=0.48,p=0.03,r=0.63,p=0.002),is positively correlated with postoperative leftventricular ejection fraction(r=0.62,p=0.03),while the atrial muscle vitamin D receptor expression and 25 oh),brain natriuretic peptide and left ventricular ejection fraction were no correlation conclusion1.Vitamin D deficiency was found in children with congenital heart disease,but there was no gender difference.2.There were no significant differences in the levels of 25 hydroxy vitamin D,left ventricular ejection fraction and brain natriuretic peptide between atrial septal defect alone,ventricular septal defect alone and combined congenital heart disease.3.The level of 25-hydroxyvitamin D decreased,but the level of left ventricular ejection fraction did not change significantly.4.25 hydroxyvitamin D has no correlation with ejection fraction and defect size,but is negatively correlated with brain natriuretic peptide.Vitamin D receptor expression was uniformly expressed in atrial and ventricular muscles,and the expression was not related to gender.However,the expression of vitamin D receptor in ventricular muscle was negatively correlated with 25 hydroxyvitamin D before and after surgery,and positively correlated with left ventricular ejection fraction after surgery.