25-羟维生素D3 Hcy LDL与无症状性脑梗死患者颈动脉斑块的关系分析

Correlation analysis of 25-hydroxyvitamin D3,Hcy,LDL and carotid plaque in patients with asymptomatic cerebral infarction

目的探讨25-羟维生素D3、Hcy、LDL与无症状性脑梗死患者颈动脉斑块的相关性。方法收集2014-01—2020-02克拉玛依市中心医院明确诊断为无症状脑梗死患者115例(SBI组),选取同期年龄、性别相匹配的123例健康者作对照(非SBI组)。入组人群均完善25-羟维生素D3、Hcy、TC、TG、HDL、LDL、头颅MRI、颈部血管超声。根据劲动脉超声将SBI组分为无斑块组、稳定斑块组和易损斑块组。采用单因素方差分析SBI组颈部血管无斑块组、稳定斑块组、易损斑块组的血清25-羟维生素D3、Hcy、TC、TG、HDL、LDL的相关性。采用Spearman相关性分析SBI组25-羟维生素D3与TC、TG、HDL、LDL、Hcy相关性。结果2组在常见脑血管病危险因素中高血压、糖尿病、TG、HDL、LDL、25-羟维生素D3、Hcy、动脉硬化、饮酒、吸烟差异均有统计学意义(P<0.05)。SBI组25-羟维生素D3水平与Hcy、TC、TG、LDL水平呈负相关,与HDL水平呈正相关。SBI组LDL在易损斑块组>稳定斑块组>无斑块组,差异有统计学意义(P=0.015)。无症状脑梗死患者25-羟维生素D3水平在劲动脉无斑块组>稳定斑块组>易损斑块组,差异有统计学意义(P=0.021)。无症状脑梗死患者Hcy水平在劲动脉无斑块组<稳定斑块组<易损斑块组,差异有统计学意义(P=0.002)。25-羟维生素D3水平与LDL、Hcy水平呈负相关(r=-4.356,P=0.015;r=-0.276,P=0.003)。结论除常见无症状脑梗死的危险因素外,颈动脉粥样硬化斑块(稳定斑块及易损斑块)、25-羟维生素D3、Hcy、LDL也是无症状脑梗死的高危因素,且易损斑块与25-羟维生素D3、Hcy关系密切,在脑梗死的发生过程中三者扮演了重要的角色。25羟维生素D3水平、Hcy、LDL可作为无症状脑梗死患者临床初筛易损斑块的血清生物学标志物。

Objective To investigate the correlation between 25-hydroxyvitamin D3,Hcy,LDL and carotid atherosclerosis in patients with asymptomatic cerebral infarction(SBI).Methods A total of 115 patients with SBI from January 2014 to February 2020 in Karamay Central Hospital were selected,and 123 healthy people matched with SBI in age and gender were selected as control group,which were divided into SBI group and non-SBI group.The subjects should improve 25-hydroxyvitamin D3,Hcy,TC,TG,HDL,LDL,head MRI and neck vascular ultrasound.The SBI group was divided into non-plaque group,stable plaque group and vulnerable plaque group.Univariate analysis of variance was used to analyze the correlation of serum 25-hydroxyvitamin D3,Hcy,TC,TG,HDL and LDL in SBI group,non-plaque group,stable plaque group and vulnerable plaque group.Spearman correlation analysis was used to analyze the correlation between 25-hydroxyvitamin D3 and TC,TG,HDL,LDL,Hcy in SBI group.Results There were significant differences in common risk factors of cerebrovascular disease between the two groups,such as hypertension,diabetes,TG,HDL,LDL,25-hydroxyvitamin D3,Hcy,arteriosclerosis,drinking and smoking(P<0.05).In SBI group,25-hydroxyvitamin D3 level was negatively correlated with Hcy,TC,TG and LDL levels,and positively correlated with HDL level.The level of LDL in SBI group was significantly higher in vulnerable plaque group than in stable plaque group and no plaque group(P=0.015).The levels of 25-hydroxyvitamin D3 in patients with SBI were significantly higher in non-plaque group than in stable plaque group than in vulnerable plaque group(P=0.021).The level of Hcy in patients with SBI was significantly higher in non-plaque group than in stable plaque group than in vulnerable plaque group(P=0.002).There was a negative correlation between 25-hydroxyvitamin D3 level and LDL level(r=-4.356,P=0.015).There was a negative correlation between 25-hydroxyvitamin D3 and Hcy(r=-0.276,P=0.003).Conclusion In addition to common risk factors for SBI,carotid atherosclerotic plaques(stable plaques and vulnerable plaques),25-hydroxyvitamin D3,Hcy,LDL are also high risk factors for SBI,and vulnerable plaques and 25-hydroxyvitamin D3 and Hcy are closely related,and they play an important role in the occurrence of cerebral infarction.The level of 25-hydroxyvitamin D3,Hcy,LDL and can be used as serum biomarkers for the initial clinical screening of vulnerable plaques in SBI patients.