高血压合并腔隙性脑梗死风险因素分析  

Analysis on risk factors of hypertension coupled with lacunar infarction

作　　者：刘继文 孟繁琴[1] 杨芳[1] 赵庆兰[1] 阿依努尔.乃买提 玛合甫扎.阿巴拜克力 阿孜古丽.阿克木江 李南方[2] LIU Jiwen;MENG Fanqin;YANG Fang;ZHAO Qinglan;Ayinuer Naimaiti;Mahefuzha Ababaikeli;Aziguli Akemujiang;LI Nanfang(Department of Internal Medicine,The People′s Hospital of Xinjiang Uyghur Autonomous Region of Midong Hospital,of Xinjiang Uyghur Autonomous Region,Hypertension Institute of Xinjiagn,Urumqi 830001,China;Hypertension Center of The People′s Hospital of Xinjiang Uyghur Autonomous Region,Hypertension Institute of Xinjiang,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院米东医院内一科,乌鲁木齐830021 [2]新疆维吾尔自治区人民医院高血压中心新疆高血压研究所,乌鲁木齐830001

出　　处：《新疆医科大学学报》2018年第12期1485-1488,共4页Journal of Xinjiang Medical University

基　　金：新疆维吾尔自治区人民医院院内项目(20140134)

摘　　要：目的探讨高血压合并腔隙性脑梗死患者临床患病特点及其相关危险因素。方法随机选取2012年2月-2015年2月就诊于新疆维吾尔自治区人民医院米东医院内一科的高血压病患者作为调查对象,测定所有研究对象胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)和空腹血糖(fasting blood glucos,FBG)等生化指标。检测患者同型半胱氨酸(Hcy)水平,以血Hcy浓度≥15μmol/L为高同型半胱氨酸血症。对颈动脉内膜厚度(IMT)进行超声检测。结果高血压不合并腔隙性脑梗死与高血压合并腔隙性脑梗死比较,左、右颈总动脉内中膜的厚度、Hcy、吸烟、饮酒及糖尿病之间差异有统计学意义(P <0.05)。将高血压合并脑梗死的危险因素进行二分类logistic回归分析,在多因素分析中,高血压患者合并糖尿病(OR=4.988,95%CI=1.966～12.655)、吸烟(OR=3.629,95%CI=1.186～11.100)、高龄(OR=1.127,95%CI=1.073～1.183)、高TC(OR=0.453,95%CI=0.216～0.952)是腔隙性脑梗死的危险因素,差异有统计学意义(P<0.05)。结论合并有糖尿病、吸烟、年龄是高血压合并脑梗死的独立危险因素。在腔隙性脑梗死的防控过程中,应根据患者的具体情况,给予积极的个性化的干预措施。Objective To investigate the clinical characteristics and related risk factors of patients with hypertension complicated with lacuna infarction.Methods A total of patients with hypertension hospitalized in the Department of Internal Medicine of the Midong Branch of the People′s Hospital of Xinjiang Uyghur Autonomous Region from February2012to February2015were selected in this study.All subjects′cholesterol(TC)and triglyceride(TG)were determined,high density lipoprotein-cholesterol(HDL-C),low density lipoprotein-cholesterol(LDL-C)and fasting blood glucos(FBG)and other biochemical indicators were tested.At the same time,the patient's homocysteine(Hcy)level was measured,and the blood Hcy concentration≥15umol/L was diagnosed for hyperhomocysteinemia.Carotid intima-media thickness(IMT)was measured using ultrasound testing.Results There was no significant difference of the thickness of the medial membrane between the left and right common carotid arteries,Hcy,smoking,alcohol consumption and diabetes in hypertension coupled with lacunar infarction group and hypertension not coupled with lacunar infarction group.Risk factors for hypertension and cerebral infarction were analyzed by two-way logistic regression.In multivariate analysis,hypertensive patients with diabetes(OR=4.988,95%CI=1.966-12.655),smoking(OR=3.629,95%CI=1.186-11.100),advanced age(OR=1.127,95%CI=1.073-1.183),high CH(OR=0.453,95%CI=0.216-0.952)are risk factors for lacunar infarction,the difference is statistically significant(P0.05).Conclusion Patients with diabetes,smoking,and age are independent risk factors for hypertension and cerebral infarction.In the prevention and control of lacunar infarction,positive and individualized interventions should be given according to the specific conditions of patients.

关 键 词：脑梗死 危险因素 同型半胱氨酸 糖尿病 颈总动脉内中膜厚度 

分 类 号：R544.1[医药卫生—心血管疾病]