血浆脂联素、同型半胱氨酸浓度与阵发性心房颤动并发腔隙性脑梗死患者的关系  

Correlation of plasma concentrations of adiponectin, homocysteine and patients with paroxysmal atrial fibrillation complicated with lacunar infarction

作　　者：彭湖[1] 陈柏荣[1] 危小良[1] 汤娇娇[2] 刘烈[2] 梁远红[2] 陈泗林[2] 陈东骊[2] 

机构地区：[1]中山大学附属第五医院心内科,广东珠海519000 [2]广东省心血管病研究所广东省人民医院(广东省医学科学院),广州510080

出　　处：《岭南心血管病杂志》2015年第5期643-645,649,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨血浆脂联素（adiponectin,ADPN）、同型半胱氨酸（homocysteine,Hcy）浓度与阵发性心房颤动（房颤）并发腔隙性脑梗死患者的关系。方法按随机数字表法随机选取16层计算机断层扫描（computed tomography,CT）平扫检查显示腔隙性脑梗死并发阵发性房颤患者50例作为研究组;另外,按随机数字表法随机入选头颅CT检查正常的50例阵发性房颤患者作为对照组。收集两组临床指标并测定血浆ADPN、Hcy浓度及其他生化指标,分析两组之间的差异;采用Logistic回归法筛选阵发性房颤患者出现腔隙性脑梗死的危险因素。结果阵发性房颤并发腔隙性脑梗死患者血浆ADPN浓度明显低于对照组,差异有统计学意义[（5.76±2.70）mg·L-1vs.（9.36±2.14）mg·L-1,P〈0.001];其血浆Hcy浓度明显高于对照组,差异有统计学意义[（16.54±4.05）μmol·L-1vs.（13.84±3.99）μmol·L-1,P=0.001]。Logistic回归分析表明,血浆ADPN浓度降低（OR=0.29,95%CI：0.170~0.504）、Hcy浓度升高（OR=1.511,95%CI：1.195~1.911）与阵发性房颤患者出现腔隙性脑梗死有独立相关性。结论血浆ADPN浓度降低、Hcy浓度升高与阵发性房颤患者并发腔隙性脑梗死密切相关,可以作为阵发性房颤并发腔隙性脑梗死患者的重要监测指标。Objectives To investigate the correlation of plasma concentrations of adiponectin,homocysteine and patients with paroxysmal atrial fibrillation complicated with lacunar infarction. Methods Fifty patients with paroxysmal atrial fibrillation proven to have lacunar infarction by 16-layer computed tomography（CT） were randomly selected as study group. Another 50 patients with paroxysmal atrial fibrillation with normal CT results were seleted as control group.Plasma concentrations of adiponectin（ADPN）, homocysteine（Hcy） and other biochemical indexes were gathered and analyzed between the two groups. Logistic regression analysis was used to screen the risk factors of lacunar infarction occurring in patients with paroxysmal atrial fibrillation. Results Plasma concentration of ADPN in study group was significantly lower than that in control group [（5.76±2.70） mg·L-1vs.（9.36±2.14） mg·L-1, P〈0.001 ], while plasma concentration of Hcy was inverse [（16.54±4.05） μmol·L-1vs.（13.84±3.99） μmol·L-1,P=0.001 ]. Logistic regression analysis showed that decreased plasma concentration of ADPN（OR=0.29, 95%CI： 0.170-0.504） and increased plasma concentration of Hcy（OR=1.511,95%CI ：1.195-1.911） were independently related to patients with paroxysmal atrial fibrillation complicated with lacunar infarction. Conclusions Decreased plasma concentration of ADPN and increased plasma concentration of Hcy are closely related to patients with paroxysmal atrial fibrillation complicated with lacunar infarction, which can be used as significant predictive indicators.

关 键 词：阵发性心房颤动 脂联素 同型半胱氨酸 腔隙性脑梗死 

分 类 号：R541.7[医药卫生—心血管疾病]