腔隙性脑梗死病人颈动脉粥样硬化与血同型半胱氨酸关系及其危险因素研究

Study on the relationship between carotid artery atherosclerosis and blood homocysteine,and its risk factors in patients with lacunar cerebral infarction

目的:探讨腔隙性脑梗死病人颈动脉粥样硬化(CAS)与血同型半胱氨酸(HCY)的相关性及其危险因素。方法:纳入腔隙性脑梗死病人200例,所有病人均行颈动脉超声检查和血HCY测定,根据颈动脉超声检查结果和血HCY水平进行分组,采用单因素分析和多因素logistic回归分析分析CAS的危险因素及与血HCY关系。结果:CAS组病人年龄、高血压和高敏C反应蛋白(hs-CRP)、HCY水平及基线收缩压(SBP)、舒张压(DBP)与非CAS组差异均有统计学意义(P<0.05~P<0.01)。CIMT斑块组病人血清HCY水平均明显高于CIMT增厚组和正常组(P<0.01),CIMT增厚组HCY水平亦明显高于正常组(P<0.01)。低HCY组病人CIMT为(0.75±0.10)mm,明显低于高HCY组的(1.26±0.13)mm(P<0.01)。Logistic回归分析结果显示,年龄、高血压、hs-CRP、HCY均为发生CAS的独立影响因素(P<0.05~P<0.01)。结论:除年龄、高血压、hs-CRP影响CAS的发生外,血HCY水平同样影响CAS的发生,临床可针对这些危险因素对CAS进行早期评估和预防。

Objective:To investigate the relationship between carotid artery atherosclerosis(CAS)and blood homocysteine(HCY),and its risk factors in patients with lacunar cerebral infarction.Methods:The carotid artery ultrasound and serum levels of HCY in 200 patients with lacunar cerebral infarction were detected.According to the results of carotid ultrasound examination and blood HCY level,the patients were grouped,and the risk factors of CAS and their relationship with blood HCY were analyzed using univariate analysis and multivariate logistic regression analysis.Results:The differences of the age,hypertension history,levels of hs-CRP and HCY,baseline SBP and SDP between non-CAS group and CAS group were statistically significant(P<0.05 to P<0.01).the serum level of HCY in CIMT plaque group was significantly higher than that in CIMT thickening group and normal group(P<0.01),and the HCY level in CIMT thickening group was also significantly higher than that in normal group(P<0.01).The CIMT in low HCY group[(0.75±0.10)mm]was significantly lower than that in high HCY group[(1.26±0.13)mm](P<0.01).The results of multiple logistic regression analysis showed that the age,hypertension history,hs-CRP and HCY were the independent influencing factors of CAS(P<0.05 to P<0.01).Conclusions:In addition to age,hypertension and HS-CRP,the blood HCY level also affects the occurrence of CAS.Early assessment and prevention of CAS can be carried out clinically based on these risk factors.