血清IMA、Hcy水平对缺血性脑白质病变诊断及评估病情的价值  

Value of the serum levels of ischemia-modified albumin and homocysteine in the diagnosis and disease assessment of white matter ischemic lesions

作　　者：王宏宇 田齐 WANG Hongyu;TIAN Qi(Hyperbaric Oxygen Chamber,The First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China)

机构地区：[1]河北北方学院附属第一医院高压氧舱室,河北张家口075000 [2]河北北方学院附属第一医院神经外科,河北张家口075000

出　　处：《中风与神经疾病杂志》2024年第2期135-139,共5页Journal of Apoplexy and Nervous Diseases

基　　金：河北省医学科学研究基金项目(20220598)。

摘　　要：目的研究血清缺血修饰白蛋白(IMA)、同型半胱氨酸(Hcy)水平与缺血性脑白质病变(WMIL)发病及病情的关系。方法选择2020年3月—2022年6月期间在我院经头部磁共振确诊为WMIL的89例患者作为WMIL组,选择同期头部磁共振结果正常、性别及年龄与WMIL患者匹配的志愿者作为对照组,比较2组间一般资料、实验室指标的差异,评价WMIL的病情并分为轻度和中重度。采用Logistic回归分析WMIL发病及严重程度的影响因素,采用ROC曲线分析血清IMA、Hcy水平对WMIL的诊断价值。结果WMIL组高血压比例、2型糖尿病比例、尿酸(UA)、IMA、Hcy水平均高于对照组(P<0.05);WMIL组中重度患者高血压比例、2型糖尿病比例、IMA、Hcy水平均高于对照组,高密度脂蛋白胆固醇(HDL-C)水平低于对照组(P<0.05);Logistic回归分析显示,高血压、IMA水平升高、Hcy水平升高是WMIL发病的影响因素(P<0.05),高血压、IMA水平升高、Hcy水平升高是WMIL病情严重程度加重的影响因素(P<0.05);ROC曲线分析显示,血清IMA、Hcy对WMIL及中重度WMIL具有诊断价值。结论血清IMA、Hcy升高与WMIL发病及病情加重相关,检测血清IMA、Hcy水平对WMIL及中重度WMIL具有诊断价值。Objective To investigate the association of the serum levels of ischemia-modified albumin(IMA)and homocysteine(Hcy)with the onset and severity of white matter ischemic lesions(WMIL).Methods A total of 89 pa‑tients who were diagnosed with WMIL by cranial magnetic resonance imaging(MRI)in our hospital from March 2020 to June 2022 were enrolled as WMIL group,and the volunteers with normal cranial MRI results,matched for sex and age,during the same period of time were enrolled as control group.The two groups were compared in terms of general informa‑tion and laboratory markers,and the conditions of WMIL were evaluated and classified into mild and moderate-to-severe cases.A logistic regression analysis was used to investigate the influencing factors for the onset and severity of WMIL,and the receiver operating characteristic(ROC)curve was used to analyze the value of the serum levels of IMA and Hcy in the diagnosis of WMIL.Results Compared with the control group,the WMIL group had a significantly higher proportion of patients with hypertension or type 2 diabetes and significantly higher levels of uric acid(UA),IMA,and Hcy(P<0.05).Compared with the control group,the WMIL group had a significantly higher proportion of the patients with moderate-to�severe WMIL who had hypertension or the proportion of type 2 diabetes,significantly higher levels of IMA and Hcy,and a significantly lower level of high-density lipoprotein cholesterol(P<0.05).The logistic regression analysis showed that hy‑pertension,elevated IMA level,and elevated Hcy level were influencing factors for the onset of WMIL(P<0.05),and hy‑pertension,elevated IMA level,and elevated Hcy level were influencing factors for the increase in WMIL severity(P<0.05).The ROC curve analysis showed that serum IMA and Hcy had a certain value in the diagnosis of WMIL and moderate-to-severe WMIL.Conclusion Increases in the serum levels of IMA and Hcy are associated with the onset and aggravation of WMIL,and measurement of the serum levels of IMA and Hcy has a certain

关 键 词：缺血性脑白质病变 缺血修饰白蛋白 同型半胱氨酸 

分 类 号：R742[医药卫生—神经病学与精神病学]