入院时同型半胱氨酸浓度与急性缺血性脑卒中患者预后之间的关系研究  

Relationship between homocysteine concentration on admission and prognosis of patients with acute ischemic stroke

作　　者：冯安琪 王嘉敏 许佳 李芳[2] 孙红伟[2] 孙艳艳[2] 孙宏巍[2] 汤颖[2] 赵景波 FENG An-qi;WANG Jia-min;XU Jia;LI Fang;SUN Hong-wei;SUN Yan-yan;SUN Hong-wei;TANG Ying;ZHAO Jing-bo(Department of Epidemiology,School of Public Health of Harbin Medical University,Harbin 150081,China;Department of Emergency Neurology,The First Affiliated Hospital of Harbin Medical University,Harbin 150001,China)

机构地区：[1]哈尔滨医科大学公共卫生学院流行病学教研室,黑龙江哈尔滨150081 [2]哈尔滨医科大学附属第一医院急诊神经内科,黑龙江哈尔滨150001

出　　处：《哈尔滨医科大学学报》2022年第2期188-193,共6页Journal of Harbin Medical University

基　　金：黑龙江省自然科学基金资助项目(D201235)。

摘　　要：目的 探讨入院时同型半胱氨酸(homocysteine, Hcy)浓度与急性缺血性脑卒中(acute ischemic stroke, AIS)高血压患者预后不良之间的关系。方法 采用队列研究,纳入2016年4月~2019年10月哈尔滨医科大学附属第一医院神经内科病房1 495例AIS患者。AIS患者按有无高血压分组。应用多元Logistic回归分析分析入院时Hcy浓度与急性缺血性脑卒中高血压患者预后的关系。结果 AIS高血压患者入院时高浓度同型半胱氨酸增加其出院时不良结局、出院后3个月、6个月、12个月不良预后结局的风险(出院时:调整后的OR=1.770,95%CI=1.282~2.444;3个月:调整后的OR=1.451,95%CI=1.031~2.043;6个月:调整后的OR=1.623,95%CI=1.083~2.430;12个月:调整后的OR=2.630,95%CI=1.439~3.871)。非高血压的AIS患者高浓度同型半胱氨酸与出院时不良结局、出院后3个月、6个月、12个月不良预后结局之间未表现出显著关系。结论 入院时高Hcy浓度增加了AIS高血压患者不良预后的风险。Objective To explore the relationship between homocysteine(Hcy) concentration on admission and the poor prognosis of acute ischemic stroke(AIS) patients with hypertension. Methods A total of 1 495 patients with AIS in the neurology ward of the First Affiliated Hospital of Harbin Medical University from April 2016 to October 2019 were enrolled. The Hcy concentration of AIS patients were grouped according to whether they had hypertension or not. Multivariate Logistic regression analysis was used to analyze the relationship between Hcy concentration and the prognosis of AIS. Results High concentrations of Hcy at admission of patients with AIS with hypertension increased the risk of poor outcomes at discharge, and the poor prognostic outcomes 3 months, 6 months, and 12 months after discharge(at discharge: adjusted OR=1.770,95%CI=1.282~2.444;3 months: adjusted OR=1.451, 95%CI=1.031~2.043;6 months: adjusted OR=1.623, 95%CI=1.083~2.430;12 months: adjusted OR=2.630, 95%CI=1.439~3.871). The high concentration of Hcy of patients with non-hypertensive with AIS did not show a significant relationship with the poor outcomes at discharge, and the poor prognostic outcomes at 3 months, 6 months, and 12 months after discharge. Conclusion High Hcy concentration on admission increases the risk of poor prognosis in patients with AIS with hypertension.

关 键 词：急性缺血性脑卒中 高血压 同型半胱氨酸 预后 队列研究 

分 类 号：R181.32[医药卫生—流行病学]