脑血管病患者总同型半胱氨酸水平与血肌酐相关性及肾脏代偿调节的性别差异分析  

Sex differences of the total homocysteine level,relationship between serum creatinine and homocysteine,and renal regulation in patients with cerebrovascular diseases

作　　者：梁国威[1] 赵媛[1] 单华[1] 徐旭[1] 王树琴[1] 

机构地区：[1]航天中心医院检验科,北京100049

出　　处：《中华检验医学杂志》2006年第3期207-210,共4页Chinese Journal of Laboratory Medicine

摘　　要：目的探讨正常血肌酐(Scr)水平脑血管病患者总同型半胱氨酸(tHcy)水平、与血肌酐的相关性及肾脏代偿调节的性别差异。方法测定脑梗死(CI)组男278例,女160例,脑出血(CH)组男22例,女16例,短暂性脑缺血发作(TIAs)组男27例,女20例的空腹血清tHcy、Scr、甘油三酯(TG)、总胆固醇(TCHO)、高密度脂蛋白胆固醇(HDLC)、低密度脂蛋白胆固醇(LDLC)并对上述3组患者伴有高血压、糖尿病的情况进行调查。结果3组间比较:CI组血tHcy明显高于TIAs组(P<0.001),CI组、CH组、TIAs组高同型半胱氨酸血症(HHe)发生率依次为41.5%、32.5%、19.1%(P=0.008);Scr水平差异无统计学意义(P>0.05)。男、女组间(CI、CH、和TIAs组,男327例、女196例)比较:tHcy差异有统计学意义[(18.36±11.30)μmol/L,(13.11±6.21)]μmol/L,P<0.001],男性明显高于女性;男性HHe发生率明显高于女性(47.1%,25.0%P<0.001);男性Scr明显高于女性(P<0.001);女性TG、TCHO、HDLC、LDLC明显高于男性(P=0.002～P<0.001);伴高血压、糖尿病男女性别之间差异无统计学意义(P>0.05)。LgtHcy与LgScr经Pearson相关分析显示:男性组相关系数r=0.166(P=0.003);女性r=0.405(P<0.001),女性相关系数明显高于男性。按性别分组、Scr分层作图显示:男性在Scr水平位于70～100μmol/L区间内肾脏对血tHcy具有明显的代偿调节作用,女性则未表现出明显的肾代偿调节。结论血tHcy水平和HHe发生率在脑血管病的不同类型中差异有统计学意义。男性较女性血tHcy明显升高是致男性较女性多发脑血管病的一个重要原因。男、女Scr水平位于70～100μmol/L区间肾脏对血tHcy代偿调节不同。Objective To explore Sex differences of total homocysteine （ tHcy ） levels, and relationship between serum creatinine and homocysteine, and renal regulation to homocysteine in patients withcerebrovascular diseases within normal serum creatinine concentrations. Me.otis The levels of fastingserum tHcy. Scr. triglyceride （ TG）. total cholesterol （ TCHO ）. high density lipoprotein cholesterol （ HDL-C ）.high density lipoprotein cholesterol（LDL-C） were determinedin groups of cerebral infarction （CI,278 malesand 160 females） ,cerebral hemorrhage（ CH,22 males and 16 females）and transient ischemic attaeks（TIAs,27 males and 20 females）. The situation that patients along with hypertension and diabetes mellitus were alsoinvestigated in three groups. Results Comparison in three groups：the tHcy concentrations were significantlyhigher in CI than in TIAs（P 〈0. 001 ）. The percentage of hyperhonocysteinemia（HHe） in CI, CH, TIAswere 41.5% ,32.5% ,19.1% （P =0. 008 ） in turn. The Scr concentrations were no significant differenceamong three groups（P 〉0. 05 ）. Sex comparison （327 males, 196 females, from CI, CH, TIAs） ： the tHcyconcentration were significantly higher in males than females F P 〈 0. 001. （18. 36±11.30）μmoL/L vs.（13.11±6.21 ）μmoL/L, respectively], the significant differences of HHe were also observed between menand women（47, 1% ,25, 0% ,P 〈 0, 001 ）. Men＇s Scr concentrations were significantly higher than women＇s （P 〈 0. 001 ）. The levels of TG,TCHO, HDL-C, LDL-C in females were significantly higher than in males（P = 0.002-P 〈 0. 001 ）. No significant differences were observed in patients along with hypertension anddiabetes mellitus between men and women. Pearson correlation analysis of Lg tHey and Lg Scr in men andwomen respectively：the correlation eoefl3eients were significantly higher in females than in males （r = 0. 405,P 〈 0.001 vs,r = 0. 166,P = 0.003）. The chart sratified by equal intervals of the Set in men and

关 键 词：脑血管障碍 半胱氨酸 

分 类 号：R743[医药卫生—神经病学与精神病学] R581.1[医药卫生—临床医学]