血浆同型半胱氨酸水平与急性卒中患者脑微出血和脑白质疏松的相关性：回顾性病例系列研究  

Correlation between plasma honmcysteine level and cerebral nicrobleeds and leukoaraiosis in patients with acute stroke： a retrospective case series study

作　　者：朱佳佳[1] 尹恝[1] 周亮[1] 赵德强[1] 方依卡[1] 潘速跃[1] 

机构地区：[1]南方医科大学南方医院神经内科,广州510515

出　　处：《国际脑血管病杂志》2012年第6期428-432,共5页International Journal of Cerebrovascular Diseases

摘　　要：目的探讨急性卒中患者血浆同型半胱氨酸（homoeysteine，Hey）水平与脑微出血（cerebral microbleed，CMB）和脑白质疏松（1eukoaraiosis，LA）的关系。方法回顾性分析急性卒中患者的临床和影像学资料，根据MRI结果对CMB进行计数和对LA严重程度进行分级，在入院后次日抽取空腹静脉血测定血浆Hey浓度。结果共纳入139例急性卒中患者，其中男性72例，女性67例，平均（70．1±10．2）岁；出血性卒中24例，缺血性卒中115例。严重LA组（n=46）的年龄[（76．23±8．74）岁对（64．58±7．42）岁；t=4．621，P=0．012]、高血压比例（89．13％对67．74％；X2=8．324，P=0．0370）和血浆Hey水平[（14．53±4．31）mmol／L对（11．31±3．16）mmol／L；t=6．538，P=0．008]显著高于非严重LA组（n=93）。Sperman相关分析显示，血浆Hey水平与L～严重程度显著相关（rs=0．365，P=0．002）。多变量logistic回归分析显示，血浆Hey水平升高[优势比（oddsratio，OR）1．336，95％可信区间（confidence interval，CI）1．141～1．526；P=0．001]和年龄（OR1．093，95％CI1．031～1．162；P=0．016）均是严重LA的独立危险因素。CMB组（n=57）的年龄[（74．37±6．35）岁对（67．56±8．52）岁；t=6．628，P=0．038]和高血压比例（94．74％对62．20％；X^2=8．773，P=0．002）显著高于非CMB组（n=82）。Spearman相关分析显示，血浆Hey水平与CMB数量无显著相关性（rs=0．038，P=0．813）。多变量logistic回归分析显示，高血压（OR5．762，95％CI1．633～22．718；P=0．010）为CMB的独立危险因素。结论血浆Hey水平增高与LA相关而与CMB无关。Objective To investigate the correlation between plasma homocysteine （Hcy） level and cerebral microbleeds （CMBs） band leukoaraiosis （LA） in patients with acute stroke. Methods The clinical and imaging data of patients with acute stroke were analyzed retrospectively. The numbers of CMBs were counted and the severity of LA was graded according to the results of MRI. Fasting venous samples were obtained and the plasma Hey conomtration was measured the next day after admission. Results A total of 139 patients with acute stroke were enrolled, 67 of them were females and 72 were males （mean age 70. 1 ± 10. 2 years）; 24 had hemorrhagic stroke and 115 had ischemic stroke. The age （76.23 ± 8. 74 years vs. 64.58 ± 7. 42 years;t= 4. 621, P=0. 012） hypertension ratio （89. 13% vs. 67. 74%;X^2 =8. 324, P=0. 0 370） and plasma Hcy level （14.53 ± 4.31 mmol/L vs. 11.31 ±3. 16 mmol/L;t =6. 538, P=0.0081 in a severe LA group （n= 46） were sigfificantly higher than those in a non-severe LA group （n = 93）. Spearman correlation analysis showed that there was significant correlation between the plasma Hcy level and the severity of LA （rs =0. 365, P =0. 002）. Multivariate logistic regression analysis showed that the increased Hcy level （odds ratio [ OR], 1. 366, 95% confidence interval [CI] 1. 141 - 1. 526; P=0. 010） and age （OR 1.093, 95% CI 1. 031 - 1. 162; P=0. 016） were the independent risk factors for severe LA. The age （74. 37 -± 6. 35 years vs. 67. 56 ± 8. 52 years; t = 6. 628, P = 0. 038） and hypertension ratio （94. 74% vs. 62. 20% ;X^2 = 8. 773, P = 0. 002） in a CBM goup were significantly higher than those in a non-CMB group （n = 82）. Spearman correlation analysis showed that there was no sigaificant correlation between the plasma Hcy level and the numbers of CBMs （rs =0. 038, P = 0. 813）. Multivariate logistic regression analysis showed that hypertension was an independent risk factor for CBMs. Conclusions The elevated plasma Hcy level was associated with LA,

关 键 词：同型半胱氨酸 卒中 脑缺血 脑出血 白质疏松症 磁共振成像 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]