Lp-PLA2,Hcy,HbA1c和LDL-C水平与脑微出血相关性研究

Study on the Relationship between Lipoprotein-Related Phospholipase A2,Homocysteine,Beta-N-1-Deoxy Fructosyl Component of Hemoglobin and Cerebral Microbleeds

目的研究脑微出血(cerebral microbleeds,CMBs)患者脂蛋白相关磷脂酶A2(lipoprotein associated phospholipase A2,Lp-PLA2)、血同型半胱氨酸(homocysteine,Hcy)、糖化血红蛋白(beta-N-1-deoxy fructosyl component of hemoglobin,HbA1c)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)水平与脑微出血的相关关系。方法采用2014年中国脑小血管病诊治共识定义,连续纳入2016年1月~2017年1月就诊于陕西省人民医院的CMBs患者62例(男性48例,女性14例),正常对照组30例(男性20例,女性10例),采集人口学资料及病史。对两组人群进行Lp-PLA2,Hcy,HbA1c和LDL-C的检查。比较两组间Lp-PLA2,Hcy,HbA1c和LDL-C水平的差异,并统计CBMs组各检验指标与CMBs数量及发生部位的相关关系。结果 CMBs组的Lp-PLA2(202.22±109.52ng/ml),Hcy(21.42±14.62μmol/L),HbA1c(6.42%±1.29%)水平均高于对照组(分别为110.11±38.51ng/ml,15.09±5.72μmol/L和5.81%±0.52%),差异具有统计学意义(t=2.67,2.97和3.24,P值均<0.05)。CMBs患者中,HbA1c水平与CMBs数量具有相关性(r=0.287,P=0.024),HbA1c水平与脑深部CMBs数量相关(r=0.304,P=0.016),而与脑皮质CMBs数量无明显相关(P>0.05)。结论 CMBs患者的Lp-PLA2,Hcy和HbA1c水平均高于正常人群。HbA1c水平与CMBs数量具有相关性,主要与脑深部CMBs数相关。

Objective To investigate the relationship between lipoprotein-related phospholipase A2（Lp-PLA2）,homocysteine （Hcy）,beta-N-1-deoxy fructosyl component of hemoglobin（HbAlc）,low density lipoprotein cholesterol（LDL-C）and cere-bral microbleeds in patients.Methods Patients with CMBs were consecutively recruited from the Department of Neurology, in Shaanxi Provincial People＆#39;s Hospital by using the diagnostic criteria according to the diagnosis and treatment of cerebral cerebrovascular disease in China in 2014.In addition,volunteers were included as normal controls.The demographic charac-teristics and the history of patients were collected.The level of Lp-PLA2,Hcy,HbA1c and LDL-C in each group was ana-lyzed.Results 62 patients with CMBs were included in this study,including 48 males and 14 females.30 patients were in-cluded into the normal control group,including 20 males and 10 females.The levels of Lp-PLA2,Hcy and HbA1c in the CMBs group were significantly higher than those in the control group（t=2.67,2.97,3.24,P〈0.05）.The level of HbA1c levels were correlated with the number of CMBs（r=0.287,P=0.024）.The level of HbA1c was correlated with the num-ber of CMBs in deep white matter（r=0.304,P=0.016）,while it was not correlated with the number of CMBs in the cortex （P〉0.05）.Conclusion The levels of Lp-PLA2,Hcy and HbA1c in CMBs were higher than those in normal control group. HbA1c levels were associated with the number of CMBs,especially in deep white matter.