高血压患者发生急性脑梗死的相关因素

Related Factors of Hypertension Patients with Acute Cerebral Infarction

【目的】探讨高血压患者发生急性脑梗死(ACI)的相关因素。【方法】回顾性分析两院收治的240例高血压患者的临床资料,根据是否发生ACI分为ACI组(126例)和非ACI组(114例)。统计并比较两组患者临床资料信息[性别、年龄、体重指数(BMI)、有无糖尿病、有无吸烟史、有无饮酒史、有无颅内血管狭窄、有无颅外血管狭窄]和实验室指标[超敏C反应蛋白(hs-CRP)、乳酸脱氢酶(LDH)、血清脂蛋白相关磷脂酶A2(Lp-PLA2)、同型半胱氨酸(Hcy)、一氧化氮(NO)、内皮型NO合成酶(eNOS)]的差异,以受试者工作特征(ROC)曲线分析相关指标预测高血压患者发生ACI的价值;采用非条件Logistic逐步回归分析明确患者发生ACI的危险因素。【结果】两组患者在性别、年龄、BMI、糖尿病发生、吸烟史、饮酒史、LDH、hs-CRP、Lp-PLA2水平方面比较,差异均无统计学意义(P>0.05),ACI组有颅内血管狭窄和颅外血管狭窄的比例显著高于非ACI组,且Hcy水平显著高于非ACI组,NO、eNOS水平显著低于非ACI组,且差异均有统计学意义(P<0.05)。经ROC分析,Hcy≥22.41μmol/L、NO≤53.28μmol/L、eNOS≤51.39 U/mL是预测高血压患者发生ACI的最佳截断值(均P<0.05);Logistic逐步回归分析显示颅内血管狭窄、颅外血管狭窄、Hcy≥22.41μmol/L、NO≤53.28μmol/L、eNOS≤51.39 U/mL是高血压患者发生ACI的危险因素(P<0.05)。【结论】颅内血管狭窄、颅外血管狭窄及Hcy、NO、eNOS水平与高血压患者发生ACI密切相关,临床上应对以上指标多加关注。

【Objective】To investigate the related factors of hypertension patients with acute cerebral infarction(ACI).【Methods】The clinical data of 240 patients with hypertension in our hospital were retrospectively analyzed.They were divided into ACI group(126 cases)and non ACI group(114 cases)according to whether ACI occurred.Clinical data information of two groups of patients[Sex,age,body mass index(BMI),diabetes,smoking,drinking,intracranial vascular stenosis,extracranial vascular stenosis]and laboratory indicators[Differences in hs-CRP,LDH,Lp-PLA2,Hcy,NO,eNOS]were counted and compared.The ROC curve was used to analyze the value of related indicators in predicting the occurrence of ACI in hypertensive patients;Non conditional logistic stepwise regression analysis was used to identify the risk factors of ACI.【Results】There was no significant difference between the two groups in terms of gender,age,BMI,diabetes,smoking history,drinking history,LDH,hs-CRP,and Lp-PLA2 levels(P>0.05).The proportion of intracranial and extracranial vascular stenosis in ACI group was significantly higher than that in the non ACI group,and the level of Hcy was significantly higher than that in the non ACI group,while the levels of NO and eNOS were significantly lower than that in the non ACI group,and the difference was statistically significant(P<0.05).According to ROC analysis,Hcy≥22.41μmol/L,NO≤53.28μmol/L and eNOS≤51.39 U/mL were the best cut-off values for predicting the occurrence of ACI in hypertensive patients(all P<0.05);Logistic stepwise regression analysis showed intracranial vascular stenosis,extracranial vascular stenosis,Hcy≥22.41μmol/L,NO≤53.28μmol/L and eNOS≤51.39 U/mL were the risk factors of ACI in hypertensive patients(P<0.05).【Conclusion】Intracranial vascular stenosis,extracranial vascular stenosis and Hcy,NO,eNOS levels are closely related to the occurrence of ACI in patients with hypertension.More attention should be paid to these indicators in clinical practice.