N-3多不饱和脂肪酸水平与脑出血之间关系的研究  

Association between levels of N-3 polyunsaturated fatty acids and intracerebral hemorrhage

作　　者：田冰锋[1] 魏小兵[1] 冯波[1] 

机构地区：[1]汉中市中心医院神经外科,陕西省汉中市723000

出　　处：《国际神经病学神经外科学杂志》2016年第3期229-232,共4页Journal of International Neurology and Neurosurgery

摘　　要：目的探究N-3多不饱和脂肪酸水平与脑出血之间的关系。方法选取2013年5月至2014年12月于本院确诊为急性期脑出血患者70例作为A组,经年龄和性别匹配后的常规心脑血管病患者70例作为B组。记录患者的临床常规参数包括身高和血压等,及血液生化参数包括血清谷草转氨酶(AST)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、二十碳五烯酸(EPA)及花生四烯酸(AA)浓度等。二元Logistic回归分析方法用于识别脑出血的关键危险因素。结果与B组相比,A组患者具有较高的舒张压和酒精摄入量(400 m L/d),较低的体质指数、HDL-C、EPA(54.3±3.2 vs 81.6±4.9 mg/m L,P<0.001)、EPA/AA比(0.33±0.12 vs 0.49±0.18,P<0.001)、蔬菜摄入(<100 g/wk)及抗高血压药使用(P<0.05)。Logistic回归分析显示较高的舒张压和酒精(400 m L/d),较低的BMI、HDL-C、EPA/AA比(风险比:0.06,P<0.05)及蔬菜摄入(<100 g/wk)是患者颅内脑出血的显著危险因素。高水平HDL-C是性别亚组(风险比:0.93和0.85,P<0.05和P<0.001)和年龄<65岁亚组(风险比:0.80,P<0.005)患者的共同危险因素,而低水平EPA(风险比:0.96,P<0.001)是≥65岁亚组患者的危险因素。结论低水平EPA浓度和EPA/AA比是脑出血的关键危险因素,尤其对于年龄≥65岁老年患者。Objective To investigate the association between the levels of N-3 polyunsaturated fatty acids and intracerebral hemorrhage. Methods Seventy patients diagnosed with acute intracerebral hemorrhage between May 2013 and December 2014 in our hospital were selected as group A,and 70 other patients with general cardio-cerebrovascular diseases matched for age and sex were selected as group B. We measured their common clinical features including height and blood pressure and blood biochemical parameters including the levels of serum aspartate aminotransferase（ AST）,low-density lipoprotein cholesterol（ LDL-C）,high-density lipoprotein cholesterol（ HDL-C）,eicosapentaenoic acid（ EPA）,and arachidonic acid（ AA）. Binary logistic regression analysis was used to identify the key risk factors for intracerebral hemorrhage. Results Compared with those in group B,the patients in group A had significantly higher diastolic blood pressure and alcohol intake（ 400 m L / d）,significantly lower body mass index（ BMI）,HDL-C,EPA（ 54. 3 ±3. 2 vs 81. 6 ± 4. 9 mg / m L,P〈0. 001）,EPA / AA ratio（ 0. 33 ± 0. 12 vs 0. 49 ± 0. 18,P〈0. 001）,and vegetable consumption（ 100 g/week）,and significantly less use of antihypertensive drug（ P〈0. 05）. The logistic regression analysis demonstrated that the significant risk factors for intracerebral hemorrhage included high diastolic blood pressure and alcohol intake（ 400 m L / d） and low body mass index,HDL-C,EPA / AA ratio（ hazard ratio： 0. 06,P〈0. 05）,and vegetable consumption（ 100 g / week）. High HDLC was a common risk factor in male and female subgroups（ hazard ratios： 0. 93 and 0. 85,P〈0. 05 and P〈0. 001,respectively） and the 65-year-old subgroup（ hazard ratio： 0. 80,P〈0. 005）,but low EPA was a risk factor only in the ≥65-year-old subgroup（ hazard ratio： 0. 96,P〈0. 001）. Conclusions Low EPA concentration and EPA / AA ratio are key risk factors for intracerebral hemorrhage,especially in patients aged 65 years or o

关 键 词：N-3多不饱和脂肪酸 脑出血 二十碳五烯酸 花生四烯酸 

分 类 号：R743.34[医药卫生—神经病学与精神病学]