Abstract: Objective　To investigate the value of vitamin D3 in the screening of cognitive impairment in elderly hypertensive patients.Methods　A total of 113 elderly hypertensive patients（>60 years） were recruited from Dongfang Hospital of Tongji University during June 2013 to June 2017.Plasma 1，25-（OH）2D3 level，Mini-Mental State Examination（MMSE） score，and other clinical data were collected.Cognitive impairment was evaluated by MMSE score.Clinical characteristics were compared between those with cognitive impairment and those without.Multivariate Logistic regression was used to analyze the influencing factors of cognitive impairment.The receiver operating characteristic（ROC） curve analysis was performed to evaluate the value of 1，25-（OH）2D3 level for the identification of cognitive impairment in these participants.Results　Of the 113 cases，28（24.8%） were found with cognitive impairment，and other 85（75.2%） without.Compared with those without cognitive impairment，elderly hypertensive patients with cognitive impairment had shorter average duration of education，lower average 1，25-（OH）2D3 level，and higher average age，higher rate of smoking history，higher prevalence of higher systolic blood pressure，and coronary heart disease（P<0.05）.Multivariate Logistic regression analysis showed that age，and 1，25-（OH）2D3 level were the influencing factors of cognitive impairment in elderly hypertensive patients（P<0.05）.The AUC of 1，25-（OH）2D3 level for the identification of cognitive impairment was 0.891，the optimal cut-off point was 66.32 nmol/L，with 69.4% sensitivity and 96.4% specificity.Conclusion　Vitamin D3 can identify cognitive impairment in elderly hypertensive patients to some extent.When it is less than 66.32 nmol/L，vitamin D should be supplemented in time.

Key words: Hypertension, Cognition disorders, Cholecalciferol, Calcitriol, Vitamin D, Aged

摘要： 目的　探讨维生素D3对老年高血压患者合并认知障碍的预测价值。方法　选取2013年6月—2017年6月在同济大学附属东方医院住院治疗的老年（>60岁）高血压患者113例。检测1，25-二羟维生素D3〔1，25-（OH）2D3〕水平以评价机体内的维生素D3水平，采用简易智力状态检查量表（MMSE）评价患者的认知功能。比较是否合并认知障碍老年高血压患者的临床资料，采用多因素Logistic回归分析探讨老年高血压患者合并认知障碍的影响因素，绘制受试者工作特征（ROC）曲线评价1，25-（OH）2D3水平对老年高血压患者合并认知障碍的预测价值。结果　113例老年高血压患者中，合并认知障碍28例（24.8%），未合并认知障碍85例（75.2%）。合并认知障碍老年高血压患者的受教育年限、1，25-（OH）2D3水平低于未合并者，年龄、收缩压、有吸烟史比例、有冠心病史比例高于未合并者（P<0.05）。多因素Logistic回归分析结果显示，年龄、1，25-（OH）2D3水平是老年高血压患者合并认知障碍的影响因素（P<0.05）。1，25-（OH）2D3水平预测老年高血压患者合并认知障碍的ROC曲线下面积为0.891，最佳诊断点为66.32 nmol/L，此时灵敏度为69.4%，特异度为96.4%。结论　维生素D3水平对老年高血压患者合并认知障碍具有一定的预测价值，当1，25-（OH）2D3<66.32 nmol/L时应及时补充维生素D。

关键词: 高血压, 认知障碍, 胆骨化醇, 骨化三醇, 维生素D, 老年人