脑梗死患者同型半胱氨酸与颈动脉内膜中层厚度的关系研究

doi:10.3969/j.issn.1673-5765.2019.06.009

摘要/Abstract

摘要：

目的探讨急性脑梗死患者颈动脉内膜中层厚度（carotid intima-media thickness，cIMT）与Hcy浓度的关系。方法收集2017年1月-2018年12月在河池市人民医院神经内科连续入院的急性脑梗死患者。应用多普勒超声检测患者cIMT，根据cIMT是否≥1 mm分为cIMT增厚组和cIMT无增厚组；测定患者血浆Hcy浓度。采用多因素分析判断血浆Hcy水平与cIMT的关系。结果共入组急性脑梗死患者226例，cIMT无增厚组34例，cIMT增厚组192例。cIMT增厚组血浆Hcy水平中位数为13.0 μmol/L，cIMT无增厚组为11.2 μmol/L，差异有统计学意义（P =0.012）。此外，cI MT增厚组的年龄（[ 69.1±9.7）岁 vs（58.2±1.2）岁，P<0.001）]、脉压差（[ 64.0±17.4）mm Hg vs（53.6±13.6） mm Hg，P <0.001）]大于cIMT非增厚组；hs-CRP高于cIMT非增厚组[3.78（1.5～10.6）mg/L vs 1.5（0.9～4.2） mg/L，P =0.010）]，差异有统计学意义。回归模型中调整了年龄、脉压差、hs-CRP水平，结果显示Hcy是 cI MT的独立影响因素，血浆Hcy每升高10 μmol/L，cI MT增加0.037 mm（95%CI 0.007～0.068，P =0.002）。结论血浆Hcy水平升高是急性脑梗死患者cIMT的独立影响因素。

文章导读： 本文对住院患者的资料进行回顾性分析，发现对于急性脑梗死患者血浆Hcy水平是颈动脉内膜中层厚度的独立影响因素，提示Hcy可能参与动脉粥样硬化起始阶段的病理过程。

关键词: 脑梗死; 颈动脉内膜中层; 同型半胱氨酸

Abstract:

Objective To investigate the correlation between carotid intima-media thickness (cIMT) and plasma Hcy concentration in patients with acute cerebral infarction. Methods Clinical data of consecutive patients with acute cerebral infarction from Department of Neurology, Guangxi Hechi People's Hospital from January 2017 to December 2018 were collected. cIMT was measured using Doppler ultrasound. According to whether the cIMT ≥1 mm or not, these patients were divided into cIMT thickening group and cIMT no-thickening group. Plasma Hcy concentration in all patients were measured. Multivariate logistic regression analysis was used to investigate the correlation between cIMT and plasma Hcy level. Results A total of 226 patients were enrolled in this study, with 34 patients in cIMT no-thickening group and 192 patients in cIMT thickening group. The median plasma Hcy level in cIMT nonthickening group was 11.2 μmol/L, and that in cIMT thickening group was 13.0 μmol/L, with statistically significant difference (P =0.012). In addition, age (69.1±9.7 years vs 58.2±1.2 years, P <0.001), pulse pressure (64.0±17.4 mm Hg vs 53.6±13.6 mm Hg, P <0.001), hs-CRP [3.78 (1.5- 10.6) mg/L vs 1.5 (0.9-4.2) mg/L, P =0.010)] in cIMT thickening group were all significantly higher than that in cIMT no-thickening group. After adjusting for age, pulse pressure, and hs-CRP level,the logistic regression analysis showed that plasma Hcy level was an independent risk factor of cIMT. For every 10 μmol/L increase in plasma Hcy level, cIMT increased by 0.037 mm (95%CI 0.0075-0.068, P =0.002). Conclusions Plasma Hcy level was an independent risk factor of cIMT in patients with acute cerebral infarction.

Key words: Cerebral Infarction; Carotid Intima-media; Homocysteine

钟旗，蓝香琳，唐革秀，李维平，潘鹏克，韦仕荣. 脑梗死患者同型半胱氨酸与颈动脉内膜中层厚度的关系研究[J]. 中国卒中杂志, 2019, 14(06): 568-572.

ZHONG Qi, LAN Xiang-Lin, TANG Ge-Xiu, LI Wei-Ping, PAN Peng-Ke, WEI Shi-Rong. Relationship between Plasm Homocysteine Level and Carotid Intima-media Thickness in Cerebral Infarction Patients[J]. Chinese Journal of Stroke, 2019, 14(06): 568-572.

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