脑小血管病与血清同型半胱氨酸、超敏C反应蛋白、血压变异性相关性研究

Correlation Between Cerebral Small Vessel Disease and Serum Homocysteine,High-sensitivity C-reactive Protein and Blood Pressure Variability

目的探讨血清同型半胱氨酸、超敏C-反应蛋白(hs-CRP)水平和血压变异性与脑小血管病的相关性。方法选取2018年12月-2020年12月合肥市第二人民医院收治的经头颅磁共振检查明确诊断为脑小血管病患者92例为观察组,另选取同期头颅MRI检查正常患者44例为对照组,比较两组血清同型半胱氨酸水平、hs-CRP水平及血压变异性情况,并采用多因素Logistic回归分析脑小血管病发病的危险因素。结果观察组同型半胱氨酸、hs-CRP水平高于对照组,差异有统计学意义(P<0.05);两组24 h收缩压SD、昼间收缩压SD、24 h舒张压SD、昼间舒张压SD、24 h动脉压SD及昼间动脉压SD比较,差异有统计学意义(P<0.05),但两组夜间收缩压SD、夜间舒张压SD、夜间动脉压SD比较,差异无统计学意义(P>0.05);多因素Logistic回归分析显示,血清同型半胱氨酸、24 h收缩压SD和hs-CRP水平是脑小血管病发生的独立危险因素。结论血清同型半胱氨酸、血清hs-CRP水平和24 h收缩压SD与脑小血管病发生密切相关,积极控制血清同型半胱氨酸、hs-CRP水平及减少收缩压变异性将有助于降低脑小血管病发病风险。

Objective To investigate the correlation between serum homocysteine,high-sensitivity C-reactive protein(hs-CRP)level,blood pressure variability and cerebral small vessel disease.Methods From December 2018 to December 2020,92 patients with cerebral small vessel disease diagnosed by cranial magnetic resonance imaging in the Second People's Hospital of Hefei were selected as the observation group,and 44 patients with normal cranial MRI were selected as the control group.The serum homocysteine level,hs-CRP level and blood pressure variability were compared between the two groups,and the risk factors of cerebral small vessel disease were analyzed by multivariate Logistic regression.Results The levels of homocysteine and hs-CRP in the observation group were higher than those in the control group(P<0.05).There were significant differences in 24 h systolic blood pressure SD,daytime systolic blood pressure SD,24 h diastolic blood pressure SD,daytime diastolic blood pressure SD,24 h arterial pressure SD and daytime arterial pressure SD between the two groups(P<0.05),but there was no significant difference in night systolic blood pressure SD,night diastolic blood pressure SD and night arterial pressure SD between the two groups(P>0.05).Multivariate logistic regression analysis showed that serum homocysteine,24 h systolic blood pressure SD and hs-CRP levels were independent risk factors for cerebral small vessel disease.Conclusion Serum homocysteine,serum hs-CRP level and 24 h systolic blood pressure SD are closely related to the occurrence of cerebral small vessel disease.Active control of serum homocysteine,hs-CRP level and reduction of systolic blood pressure variability will help reduce the risk of cerebral small vessel disease.