心血管因素及血清高半胱氨酸水平升高与脑梗死患者死亡风险的相关分析

Correlation between cardiovascular factors,elevated serum homocysteine level and death risk in patients with cerebral infarction

目的探讨心血管因素及血清高半胱氨酸(Hcy)水平升高与脑梗死患者1年死亡风险的相关性。方法回顾性分析369例脑梗死患者临床资料及1年内生存情况。用χ2检验分析正常组和异常组死亡率差异,单因素Cox比例风险回归分析各危险因素的风险比,并绘制累计死亡曲线。结果心脏形态异常、颈动脉斑块形成及血清Hcy水平升高患者的死亡率较对照组增高(P<0.05)。单因素Cox风险比例回归分析显示心脏形态异常、颈动脉斑块形成以及Hcy水平升高均与患者1年死亡风险增高相关(P<0.05)。结论脑梗死患者心脏形态异常、颈动脉斑块形成及血清Hcy高水平可增加脑梗死患者1年内死亡风险。

Objective To evaluate the corelation between cardiovascular factors, elevated serum homocysteine （Hcy） level and death risk in patients with cerebral infarction（CI） within one year after onset. Methods A hospital-based cohort of 369 consecutive CI patients was reviewed retrospectively. The mortality difference between abnormal group and normal group （control） was distinguished by Chi-square test, and odds ratio estimates were calculated according to univariate Cox＇s Proportional Hazard Regression analysis. A cumulative hazard curve was plotted in order to explore the mortality difference between the two groups. Results The mortality in the patients with abnormalities of cardiac structure, carotid atherosclerosis and elevated serum Hcy was higher than the normal group （ P 〈 0.05 ）. The univariate Cox＇s Proportional Hazard Regression analysis indicated abnormalities of cardiac structure, carotid atherosclerosis and elevated serum Hcy correlated with elevated death risk in one year （ P 〈 0.05 ）. Conclusion The abnormalities of cardiac structure, carotid atheroselerosis and elevated serum Hey level may significantly increase the risk of death of CI patients.