血清同型半胱氨酸和低密度脂蛋白胆固醇与颈动脉斑块的关系  

The Relationship Between Serum Homocysteine,Low Density Lipoprotein Cholesterol and Common Carotid Atherosclerosis

作　　者：吴继华[1] 沈昊[1] 徐震[1] 郝天波 朱同华[1] 沈国荣[1] 

机构地区：[1]南通大学附属吴江医院检验科,江苏吴江215200

出　　处：《标记免疫分析与临床》2015年第10期1008-1011,共4页Labeled Immunoassays and Clinical Medicine

摘　　要：目的明确同型半胱氨酸（Hcy）和低密度脂蛋白胆固醇（LDL-C）是否为动脉粥样硬化的独立危险因素。探讨Hcy、LDL-C对颈动脉斑块的影响。方法采用生化法测定200例患者血清Hcy、甘油三脂（TG）、总胆固醇（TC）、高密度脂蛋白（HDL-C）、LDL-C、血尿酸（UA）、血糖（GLU）等指标。以高频超声确定患者颈动脉斑块的有无,依斑块的有无分为无斑块组102例,斑块组98例,对比两组间Hcy、血脂、血尿酸、年龄、收缩压等的差异以及糖尿病、血脂异常、吸烟的比例在两组间的差异。采用Logistic分析方法确定患者颈动脉发生斑块的危险因素。结果在无斑块组和有斑块组间Hcy（14.8±5.3 vs 18.3±6.2μmol/L,P〈0.01）和LDL-C（2.92±0.71 vs 3.19±0.89 mmol/L,P〈0.05）存在明显的差异;UA（310.6±82.7 vs 339.3±89.3μmol/L,P〈0.05）、吸烟的比例（17.6%vs 33.7%,P〈0.05）、收缩压（157.6±19.6 vs169.1±62.8mm Hg,P〈0.05）在两组间也存在显著差异。而其它因素,包括年龄、性别、HDL-C、TG、TC在两组间均无显著差异（P均〉0.05）。Logistic回归分析显示：Hcy和LDL-C是患者颈动脉粥样硬化斑块形成的独立危险因素,两者的相对危险度（OR）和95%可信区间（95%CI）分别为1.471（1.039~1.503）和1.861（1.105~1.976）。结论同型半胱氨酸和低密度脂蛋白胆固醇是患者颈动脉粥样硬化斑块形成的独立危险因素。Objective To verify whether serum homocysteine（Hcy） and low density lipoprotein cholesterol（ LDL- C） are independent risk factors for common carotid atherosclerosis（As） , and to explore the different effects of Hcy, LDL- C on common carotid atherosclerosis. Methods 200 patients were recruited and their common carotid atherosclerosis were measured by high resolved liner array transducer. According to whether there was a plaque, patients were divided into no-As groups （n = 102 ）and As groups （n = 98 ）. At the same time the serum samples were collected for determining the levels of Hcy, triglyceride （TG）, total cholesterol （TC）, high-density lipoprotein cholesterol （ HDL- C ）, low- density lipoprotein cholesterol （ LDL- C ） , Uric acid （ UA ） , glucose （GLU） by biochemistry. The results were analyzed to determine the risk factors for common carotid atherosclerosis. Results There were significant differences in Hcy（ 14.8 ± 5.3 vs 18.3 ± 6.2μmol/L, P 〈 0.01）, LDL-C（2. 92 ±0. 71 vs 3. 19 ±0. 89mmol/L, P 〈0.05）,UA（310. 6 ±82. 7 vs 339. 3 ± 89.3 μmol/L, P〈0. 05） ,the rates of smoking（17.6% vs 33.7%, P 〈0.05）, SBP（157.6 ± 19.6 vs 169.1_＋62.8mmHg, P 〈 0.05 ）between the two groups. No difference were seen in the other factors （age, gender, HDL-C, TG, TC ） between two groups （ P 〉 0. 05 ）. Multiple logistic regression analysis results indicated that Hey and LDL- C were the independent risk factors of As. The odds ratio （OR） and 95 % confidence internal（95% CI）were 1. 471 （1. 039-1. 503 ）for Hcy and 1. 861 （1. 105-1. 976 ）for LDL-C, respectively. Conclusion The Hey and LDL-C are the independent risk factors of atherosclerosis.

关 键 词：同型半胱氨酸 低密度脂蛋白胆固醇 颈动脉粥样硬化 危险因素 

分 类 号：R543.4[医药卫生—心血管疾病] R446.11[医药卫生—内科学]