同型半胱氨酸水平与脑白质病变严重程度的相关性研究

Homocysteine levels is associated with the severity of brain white matter lesions

目的:通过比较不同程度脑白质病变(white matter lesions,WMLs)患者的同型半胱氨酸(homocysteine,Hcy)水平,探讨Hcy是否可作为WMLs的危险因素及严重程度的预测指标。方法:回顾性分析2021年5月―2022年5月期间于成都市第七人民医院天府院区神经内科住院的798例患者的临床资料,应用Fazkas量表对患者WMLs程度进行定量测定,将患者分为对照组(0分)、WMLs组(1~6分);其中WMLs组按病灶情况分为轻度WMLs组(1~2分)、中度WMLs组(3~4分)、重度WMLs组(5~6分)。结果:对照组和WMLs组之间比较,患者的年龄、糖尿病比率、高血压比率、高血脂比率、Hcy值、Hcy分级、HHcy比率差异均有统计学意义(均P<0.05)。对照组、轻度WMLs组、中度WMLs组、重度WMLs组4组间年龄、性别、糖尿病比率、高血压比率、高血脂比率、吸烟史、饮酒史、Hcy值、Hcy分级、HHcy比率差异均有统计学意义(均P<0.05)。Hcy分级与Fazkas量表评分之间呈正相关关系(Kendall′s tau-b=0.432,P<0.001)。有序Logistic回归分析显示:年龄、糖尿病、高血压、高血脂、HHcy均为WMLs的危险因素。结论:年龄、糖尿病、高血压、高血脂、HHcy为WMLs的危险因素,Hcy分值越高,WMLs越严重。积极干预高Hcy水平可能对减轻WMLs具有正面价值。

Objective:To explore whether Hcy can be used as a risk factor and severity of cerebral white matter lesions(WMLs)by comparing homocysteine(Hcy)levels in patients with different degrees of WMLs.Methods:The clinical data of 798 patients hospitalized in Neurology of Tianfu Hospital of Chengdu Seventh People′s Hospital from May 2021 to May 2022,was analyzed to determine the degree of WMLs of the patients by Fazkas scale,and the patients were divided into control group(0 point),WMLs group(1-6 points);WMLs group was divided into mild WMLs group(1-2 points),moderate WMLs group(3-4 points),and severe WMLs group(5-6 points).Results:In comparison between the control and WMLs groups,the age,diabetes mellitus ratio,hypertension ratio,hyperlipidemia ratio,Hcy value,Hcy grade,and HHcy rate were significant(all P<0.05).Age,gender,diabetes ratio,hypertension ratio,hyperlipidemia ratio,smoking history,alcohol history,Hcy value,Hcy grade,and HHcy ratio among control group,mild WMLs group,moderate WMLs group,and severe WMLs group(all P<0.05).There was a positive correlation between Hcy grade and Fazkas scale score(Kendall′s tau-b=0.432,P<0.001).Ordered Logistic regression analysis showed that age,diabetes mellitus,hypertension,hyperlipidemia,and HHcy were all risk factors for WMLs.Conclusion:Age,diabetes mellitus,hypertension,hyperlipemia,and HHcy were risk factors for WMLs.The higher the Hcy value,the more severe the WMLs are.And active intervention to high Hcy levels may have a positive value in reducing WMLs.