血脂联合同型半胱氨酸预测高血压脑出血的价值

Value of Blood Lipid Combined with Homocysteine in Predicting Hypertensive Intracerebral Hemorrhage

目的探讨血清同型半胱氨酸(homocysteine,Hcy)及不同血脂成分对高血压脑出血的影响。方法收集笔者医院2018年1月~2019年12月确诊原发性高血压患者的病例资料1248例,以高血压脑出血为研究组(n=339),原发性高血压为对照组(n=909)。收集性别、年龄、入院血压值、血脂及血清Hcy水平。计数数据采用χ^(2)检验,计量数据采用t检验。结果研究组共纳入339例患者,对照组909例,研究组患者血清Hcy、胆固醇(cholesterol,TC)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)水平显著高于对照组,差异均有统计学意义(P均<0.05)。Logistic回归分析显示,高同型半胱氨酸血症(HHcy)(OR=6.97,95%CI:3.29~14.80,P=0.01)、TC(OR=1.13,95%CI:1.19~1.50,P=0.01)、LDL-C(OR=5.78,95%CI:3.49~9.59,P=0.01)及年龄(OR=1.05,95%CI:1.03~1.06,P=0.01)是高血压患者发生脑出血的危险因素。ROC曲线结果显示,Hcy、TC、LDL-C及三者联合预测高血压脑出血的AUC面积分别为0.697、0.862、0.833和0.869。结论高血压脑出血患者拥有更高的血清Hcy、TC、LDL-C水平,且3项指标联合对高血压脑出血的诊断具有较高的预测能力。

Objective To analyze the effect of homocysteine combined with lipid index on Hypertensive Intracerebral Hemorrhage. Methods The data of 1248 patients with hypertension in our hospital from January 2018 to December 2019 were collected, including the gender, age hcy the level of SBP,systolic pressure blood-liqid and serum retrospectively.Patients with intracerebral hemorrhage were designed as the study group(n=339) and the control group(n=909) was not complicated with intracerebral hemorrhage.The differences among groups were compared by using independent-sample t test or χ^(2) test. ROC working curve was used to find the cut-off point.Results A total of 339 patients were included in the study group and 909 in the control group, the levels of Hcy, cholesterol(TC) and low density lipoprotein cholesterol(LDL-C) in the study group were significantly higher than those in the control group(P<0.05). Logistic regression analysis, HHcy(OR=6.97,95% CI:3.29-14.80,P=0.01), TC(OR=1.13,95% CI:1.19-1.50,P=0.01), LDL-C(OR=5.78,95% CI:3.49-9.59,P=0.01) and age(OR=1.05,95% CI:1.03-1.06,P=0.01) were risk factors for intracerebral hemorrhage in patients with hypertension.The ROC curve showed that the area under the curve(AUC) of Hcy, TC,LDL-C were 0.697, 0.862, 0.833,and the combined area under the AUC was 0.869.Conclusion The serum Hcy concentration, TC and LDL-C levels were higher in patients with hypertensive intracerebral hemorrhage, the predicting value of the Hcy, TC, LDL-C combined was higher than its respective value.