老年患者血管源性脑白质病变与血游离脂肪酸的相关性研究  

Correlation of Blood Free Fatty Acids in Elderly Patients with Vasogenic White matter lesions

作　　者：吕书悦 李松涛[1] 吴凡 赵晴[1] LV Shu-yue;LI Song-tao;WU Fan(Department of Neurology,South Lake,China-J apan Union Hospital of Jilin University·Engineering Laboratory of Memory and Cognitive Impairment Disease Jilin Province,Changchun 130033,China)

机构地区：[1]吉林大学中日联谊医院南湖神经内科·吉林省记忆与认知障碍疾病工程实验室,吉林长春130033

出　　处：《中国实验诊断学》2022年第8期1194-1198,共5页Chinese Journal of Laboratory Diagnosis

基　　金：吉林省科技发展计划项目(20200404076YY);吉林省记忆与认知障碍疾病工程实验室(2020C054)。

摘　　要：目的分析老年患者血管源性脑白质病变与血游离脂肪酸的相关性。方法纳入2020年9月-2021年7月在吉林大学中日联谊医院南湖神经内科住院的脑小血管病患者194例,根据头MR显示的脑白质病变程度进行Fazekas评分,按照评分结果对纳入患者进行分级。收集患者的一般资料、低密度脂蛋白胆固醇、血同型半胱氨酸及血游离脂肪酸等数据。比较不同程度脑白质病变患者的一般资料及血游离脂肪酸。结果(1)不同程度的脑白质病变患者在吸烟史、高血压病史、年龄、同型半胱氨酸、月桂酸、山嵛酸、花生酸、硬脂酸、二十二碳六烯酸、二十碳五烯酸存在明显差异(P<0.05);(2)血游离脂肪酸与脑白质病变分级的相关性分析:月桂酸(r=-0.314,P<0.001)、山嵛酸(r=-0.164,P=0.022)、硬脂酸(r=0.182,P=0.011),二十二碳六烯酸(r=0.149,P=0.038),二十碳五烯酸(r=-0.0167,P=0.020)存在差异(P<0.05);(3)对脑白质病变分级行多因素logistic回归分析显示年龄、高血压病史、月桂酸、同型半胱氨酸、硬脂酸与脑白质病变严重程度存在独立相关性。结论月桂酸和硬脂酸与脑白质病变的严重程度具有独立相关性,血液中月桂酸水平越低、硬脂酸水平越高,脑白质病变越重。因此月桂酸与硬脂酸可在一定程度上反映脑白质病变的程度,在临床上具有预测价值,为脑白质病变的诊断及治疗提供新的思路。Objective To analyze the correlation of blood free fatty acids in elderly patients with vasogenic White matter lesions.Methods A total of 267CSVD patients hospitalized in Nanhu Department of Neurology,China-Japan Friendship Hospital,Jilin University from September 2020to July 2021were included,among which 194met the inclusion criteria.Fazekas score was performed according to the degree of leukoencephalopathy shown by head MR,and the included patients were graded according to the score results.General data,low density lipoprotein cholesterol,blood homocysteine and blood free fatty acid were collected.To compare the general data and blood free fatty acids of patients with different degrees of leukoencephalopathy.Results(1)There were significant differences in smoking history,hypertension history,age,HCY,lauric acid,behenic acid,arachidonic acid,stearic acid,docosahexaenoic acid and eicosapentaenoic acid among patients with different degrees of leukoencephalopathy(P<0.05);(2)Correlation analysis between blood free fatty acids and white matter lesion grading:Lauric acid(r=-0.314,P<0.001),behenic acid(R=-0.164,P=0.022),stearic acid(r=0.182,P=0.011),docosahexaenoic acid(R=0.149,P=0.038),Eicosapentaenoic acid(R=-0.0167,P=0.020)was significantly different(P<0.05);(3)Multifactor logistic regression analysis of WML grading showed that age,history of hypertension,lauric acid,Hcy,stearic acid were independently correlated with WML severity.Conclusion Lauric acid and stearic acid were independently correlated with the severity of leukodystrophy.The lower the level of lauric acid and the higher the level of stearic acid in blood,the more severe the leukodystrophy.Therefore,the levels of lauric acid and stearic acid can reflect the degree of leukodystrophy to a certain extent,which has clinical predictive value and provides new ideas for the diagnosis and treatment of leukodystrophy.

关 键 词：脑白质病变 血游离脂肪酸 月桂酸 硬脂酸 

分 类 号：R741[医药卫生—神经病学与精神病学]