同型半胱氨酸和血脂循环水平与动脉粥样硬化性缺血性脑卒中的相关性研究  

Correlation between the circulating levels of homocysteine and blood lipids and atherosclerotic ischemic stroke

作　　者：张英杰 赵波 刘璇 冷慧层 尹榕 ZHANG Yingjie;ZHAO Bo;LIU Xuan;LENG Huiceng;YIN Rong(The 940th Hospital of Joint Logistics Support Force of the People’s Liberation Army,Lanzhou 730050,China;First School of Clinical Medical,Gansu University of Chinese Medicine,Lanzhou 730030,China;Gansu Provincial Central Hospital,Lanzhou 730070,China)

机构地区：[1]解放军联勤保障部队第九四〇医院,甘肃兰州730050 [2]甘肃中医药大学第一临床医学院,甘肃兰州730030 [3]甘肃省中心医院,甘肃兰州730070

出　　处：《中国实用神经疾病杂志》2022年第3期306-311,共6页Chinese Journal of Practical Nervous Diseases

基　　金：军事医学创新工程(编号:19SWAQ13)。

摘　　要：目的探讨同型半胱氨酸(homocysteine,Hcy)和血脂循环水平与动脉粥样硬化性缺血性脑卒中(ischemic stroke,IS)的相关性。方法纳入2019-12—2021-05解放军联勤保障部队第九四〇医院收治的动脉粥样硬化性IS患者345例,根据发病时间分为急性期IS组(216例)和非急性期IS组(129例),再根据TOAST(Trial of Org 10172 in Acute Stroke Treatment,TOAST)病因分型分为4个亚组,即急性期Ⅰ型IS和Ⅲ型IS组、非急性期Ⅰ型IS和Ⅲ型IS组,比较急性期IS组和非急性期IS组及各亚组间临床资料,分析急性期IS与Hcy、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)的相关性。结果在急性期IS和非急性期IS组、急性期Ⅰ型IS和非急性期Ⅰ型IS组、急性期Ⅲ型IS和非急性期Ⅲ型IS组中,Hcy和LDL-C的循环水平在急性期IS组、急性期Ⅰ型IS组和急性期Ⅲ型IS组中均更高,差异有统计学意义(P<0.05)。Spearman相关性分析发现,急性期IS与Hcy(r=0.278)、LDL-C(r=0.227)呈正相关(P<0.01),急性期Ⅰ型IS与Hcy(r=0.218)、LDL-C(r=0.296)呈正相关(P<0.05),急性期Ⅲ型IS与Hcy(r=0.293)、LDL-C(r=0.219)也呈正相关(P<0.01)。结论Hcy和LDL-C循环水平在TOAST病因分型为大动脉粥样硬化型(Ⅰ型)和(或)小动脉闭塞型(Ⅲ型)的动脉粥样硬化性IS的急性期中升高。Objective To investigate the correlation between the circulating levels of homocysteine and blood lipids and atherosclerotic ischemic stroke.Methods Totally 345 patients with atherosclerotic ischemic stroke(IS)admitted to the 940th Hospital of Joint Logistics Support Force of the People’s Liberation Army from December 2019 to May 2021 were included.According to their onset time,they were divided into acute phase IS group(216 cases)and non-acute phase IS group(129 cases).Further according to the trial of org 10172 in acute stroke treatment(TOAST)etiology classification,they were divided into 4 subgroups,namely the acute typeⅠIS group and the acute typeⅢIS group,the non-acute typeⅠIS group,the non-acute typeⅢIS group.The differences in clinical data of the acute phase IS group and the non-acute phase IS group and between each subgroup were compared.The correlation between whether acute IS and Hcy,low-density lipoprotein cholesterol(LDL-C)were analyzed.Results In the acute phase IS group and the non-acute phase IS group,the acute typeⅠIS group and the non-acute typeⅠIS group,the acute typeⅢIS group and the non-acute typeⅢIS group,both Hcy and LDL-C had higher circulating levels in the acute phase IS group and the acute typeⅠIS group,the acute typeⅢIS group,and the difference was significant(P<0.05).Through Spearman correlation analysis,acute phase IS was positively correlated with Hcy(r=0.278)and LDL-C(r=0.227)(P<0.01),acute typeⅠIS was positively correlated with Hcy(r=0.218)and LDL-C(r=0.296)(P<0.05),acute typeⅢIS was also positively correlated with Hcy(r=0.293)and LDL-C(r=0.219)(P<0.01).Conclusion The circulating levels of Hcy and LDL-C are elevated in the acute phase of atherosclerotic IS of the TOAST etiology classification of large atherosclerosis(typeⅠ)and(or)small artery occlusion(typeⅢ).

关 键 词：缺血性脑卒中 动脉粥样硬化 同型半胱氨酸 低密度脂蛋白胆固醇 相关性 

分 类 号：R743.33[医药卫生—神经病学与精神病学]