脑小血管疾病患者血清同型半胱氨酸水平的临床研究  

Serum Total Homocysteine Concentrations in Cerebral Small-Vessel Disease

作　　者：宋铁军[1] 黄珺[1] 

机构地区：[1]浙江大学医学院附属邵逸夫医院,浙江杭州310016

出　　处：《实用医技杂志》2007年第8期937-939,共3页Journal of Practical Medical Techniques

摘　　要：目的:探讨同型半胱氨酸(Hcy)水平与脑小血管疾病(SVD)的关系,了解SVD的危险因素。方法:腔隙性脑梗死患者(LI)96例,根椐腔隙数目分为单发性腔梗组(SLI)和多发性腔梗组(MLI),根据脑白质疏松(LA)有无分为LA组和无LA组;大动脉粥样硬化性脑梗死(AI)组患者78例和对照组35例,比较各组之间的患者tHcy水平,评价tHcy水平和LI的传统危险因素的关系。结果:脑梗死患者血清tHcy水平显著高于对照组(P<0.01),LI组与AI组之间差异无显著性(P>0.05);MLI组患者tHcy水平高于SLI,LA组患者则高于无LA组,差异有统计学意义(P<0.01)。LI患者tHcy水平与传统危险因素等各指标无相关性。经多因素logistic回归和ROC曲线分析,tHcy(OR=1.335,Az=0.882)是LI的较强的预测指标,同时tHcy(OR=1.063)也是脑白质疏松症的危险因素。结论:高tHcy与LI及其脑白质疏松症有关,是SVD的一个重要的危险因素,至于Hcy在SVD的致病机制有待于进一步研究。Objactive To study the relation between homocysteine （Hcy） levels and cerebral small-vessel disease （SVD）, and atherosclerotic risk factors. Methods The subjects comprised patients with lacunar infarction （n = 96） ,atherothrombotic infarction （AI） （ n = 78 ） ,without infarction （ n = 35 ）. 96 lacunar infarction were divided into subgroups ： single large infarction （SLI） and multiple large infarction （MLI）;Infarction with leukoaraiosis （LA） and Infarction without LA,according to brain MRI findings. The relations between tHcy and traditional atherosclerotic risk factors were analyzed. Results tHcy level in patients with infarction was higher than that in patients without infarction （P 〈0.01 ） ,but their level had no difference between lacunar infarction and atherothrombotic infarction （P 〈 0.05 ）. tHcy level was higher in MLI than that in SLI, which in LA than that in without LA （P 〈 0.01 ）. Relations between tHcy and hypertension, diabetes, blood lipid, smoking were not significant. By multivariate regression and ROC analyses, tHcy （ OR = 1. 335, Az = 0. 882） was an stronger marker to predict lacunar infarction ,particularly with LA （OR = 1. 063 ）. Conclusion Hyperhomocysteine were related to lacunar infarction and leukoaraiosis. It suggested that high level of tHcy may be important risk factor of cerebral small-vessel disease, and the mechanism involvled in cerebral infarction was still to elucidate.

关 键 词：脑梗死 同型半胱氨酸 脑小血管疾病 

分 类 号：R743.3[医药卫生—神经病学与精神病学]