伴同型半胱氨酸增高的缺血性卒中患者相关危险因素Logistic回归分析

Non-Conditional Logisitic Regression Analysis on Risk Factors of Homocysteine Increasing in Patients with Ischemic Stroke Disease

目的:分析伴同型半胱氨酸(Hcy)增高的缺血性卒中患者(IS)的相关危险因素。方法:共纳入80例经头颅MRI/CT证实的且Hcy水平>20μmol/L的IS患者,同时随机抽取138例不伴Hcy增高的IS患者作为对照组。所有受试者均记录IS的传统危险因素。先以单因素分析筛选出有统计学意义的危险因素,再应用多因素非条件Logistic回归分析伴Hcy增高的IS患者的独立危险因素。结果:单因素分析表明:生活规律及高密度脂蛋白(HDL)与伴Hcy增高的IS患者呈负相关(P<0.05);男性、高血压病史、糖尿病史、家族卒中病史、冠心病病史、吸烟史、饮酒史、入院首次收缩压、C反应蛋白(CRP)及LDL与之呈正相关(P<0.05)。多因素分析表明:高血压病史、糖尿病史、吸烟史、CRP及LDL是伴Hcy增高的IS患者的独立危险因素;而生活规律是伴Hcy增高的IS患者的保护因素。结论:伴Hcy增高的IS患者的保护因素是生活规律,其独立危险因素是高血压病史、糖尿病史、吸烟史、CRP及LDL,对该类人群的高血压、糖尿病等危险因素进行必要的干预具有重要的意义。

Objective： To investigate the risk factors of ischemic stroke（IS） patients with increased homocysteine（Hcy）.Methods： Eighty hospitalized patients of IS with Hcy 8 mg/L and 138 control subjects without clinical and instrumental evidence of atherosclerosis diseases were enrolled.All traditional risk factors for IS and biochemical indexes were recorded.Several statistically significant risk factors were screened out with univariate non-conditional logistic regression analysis,then independent risk factors were determined with multivariate stepwise non-conditional logistic regression analysis.Results： Univariate non-conditional logistic regression analysis showed that male,hypertension,heart disease,diabetes,smoking,alcohol abuse,familiar stroke history,SBP,LDL and CRP were positively correlated with Hcy increasing in patients with IS（P0.05）.Regular liftstyle and HDL were negatively correlated with increasing in Hcy in patients with IS.Multivariate stepwise non-conditional logistic regression analysis showed that male,hypertension history,diabetes history and smoking were the independent risk factors of increasing in Hcy in patients with IS.Conclusion： Healthy lifestyle was protective factors against increasing in Hcy in patients with IS;hypertension,diabetes and smoking were independent risk factors for increasing in Hcy in patients with IS.Interventional treatment on related risk factors is necessary to ischemic stroke patients with increased Hcy.