同型半胱氨酸、血脂比值及血糖在急性缺血性脑卒中患者的相关性及其影响因素分析  

Correlation and influencing factors analysis of homocysteine,lipid ratio and blood glucose in patients with acute ischemic stroke

作　　者：宾广健 黄朝任 邹光美 罗宇飞 陆日秋 BIN Guangjian;HUANG Chaoren;ZOU Guangmei;LUO Yufei;LU Riqiu(Department of Clinical Laboratory,Traditional Chinese Medicine Hospital of Yulin,Guangxi Zhuang Autonomous Region,Yulin537000,China;Department of Clinical Laboratory,the First People's Hospital of Yulin,Guangxi Zhuang Autonomous Region,Yulin537000,China)

机构地区：[1]广西壮族自治区玉林市中医医院检验科,广西玉林537000 [2]广西壮族自治区玉林市第一人民医院检验科,广西玉林537000

出　　处：《中国当代医药》2024年第18期111-114,共4页China Modern Medicine

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20200376)。

摘　　要：目的探讨同型半胱氨酸(Hcy)、血脂比值及血糖(GLU)在急性缺血性脑卒中(AIS)患者的相关性及其影响因素。方法选取2020年7月至2022年12月于玉林市中医医院就诊的154例AIS患者及同期154名体检健康者为研究对象,将AIS患者纳入AIS组,体检健康者纳入对照组,比较两组的Hcy、血脂比值及GLU等水平,采用Pearson法分析Hcy与血脂四项、GLU的相关性,采用多因素二元logistic回归分析AIS发生的影响因素。结果AIS组的Hcy、总胆固醇(TC)、三酰甘油(TG)及低密度脂蛋白胆固醇(LDL-C)高于对照组,而AIS组的高密度脂蛋白胆固醇(HDL-C)水平低于对照组,差异有统计学意义(P<0.05);AIS组的血脂TC/HDL-C、TG/HDL-C、LDL-C/HDL-C比值和GLU水平均高于对照组,差异有统计学意义(P<0.05)。Pearson相关分析结果显示,Hcy与TC、TG、HDL-C、LDL-C和GLU呈负相关(r=-0.086、-0.038、-0.055、-0.060、-0.038,P<0.001)。多因素二元logistic回归分析结果显示,高Hcy(β=0.381,OR=1.464,95%CI=1.444~1.483)、高TG(β=1.001,OR=2.720,95%CI=2.567~2.882)、高LDL-C(β=0.356,OR=1.428,95%CI=1.374~1.483)、高GLU(β=0.343,OR=1.409,95%CI=1.370~1.449)、TC/HDL-C升高(β=0.540,OR=1.715,95%CI=1.344~2.189)、TG/HDL-C升高(β=1.113,OR=3.044,95%CI=1.941~4.773)、LDL-C/HDL-C升高(β=0.776,OR=2.172,95%CI=1.553~3.038)为AIS的危险因素(P<0.001),而高HDL-C(β=-1.608,OR=0.200,95%CI=0.183~0.219)为AIS的保护因素(P<0.001)。结论AIS患者的Hcy、血脂、血脂比值及GLU水平与AIS发生密切相关,其Hcy、TG、LDL-C、GLU、TC/HDL-C、TG/HDL-C、LDL-C/HDL-C可能是AIS的危险因素,而HDL-C可能是AIS的保护因素,以上指标对临床诊疗及评估影响因素有重要参考价值。Objective To explore the correlation and influencing factors analysis of homocysteine(Hcy),lipid ratio,and blood glucose(GLU)detection in acute ischemic stroke(AIS).Methods A total of 154 patients with AIS who visited Traditional Chinese Medicine Hospital of Yulin from July 2020 to December 2022,as well as the 154 healthy individuals who underwent physical examinations during the same period were selected as the study subjects.The AIS patients were included in the AIS group,and the healthy people were included in the control group.The differences in Hcy,blood lipid ratio and GLU levels between the two groups were compared.Pearson analysis was used to analyze the correlation between items,and multiple factor binary logistic regression was used to analyze the influencing factors of AIS occurrence.Results The levels of Hcy,total cholesterol(TC),triglycerides(TG),and low-density lipoprotein cholesterol(LDL-C)in the AIS group were higher than those in the control group,while the level of high-density lipoprotein cholesterol(HDL-C)in the AIS group was lower than that in the control group,with statistically significant differences(P<0.05).The blood lipid TC/HDL-C,TG/HDL-C,LDL-C/HDL-C ratio,and GLU levels in the AIS group were higher than those in the control group,and the differences were statistically significant(P<0.05).Pearson analysis showed that Hcy was negatively correlated with TC,TG,HDL-C,LDL-C,and GLU(r=-0.086,-0.038,-0.055,-0.060,-0.038;P<0.001).The results of the multivariate binary logistic regression analysis showed that high Hcy(β=0.381,OR=1.464,95%CI=1.444-1.483),high TG(β=1.001,OR=2.720,95%CI=2.567-2.882),high LDL-C(β=0.356,OR=1.428,95%CI=1.374-1.483),high GLU(β=0.343,OR=1.409,95%CI=1.370-1.449),TC/HDL-C increase(β=0.540,OR=1.715,95%CI=1.344-2.189),TG/HDL-C increase(β=1.113,OR=3.044,95%CI=1.941-4.773),LDL-C/HDL-C increase(β=0.776,OR=2.172,95%CI=1.553-3.038)were risk factors for AIS(P<0.001),while high HDL-C(β=-1.608,OR=0.200,95%CI=0.183-0.219)was a protective factor for AIS(P<0.001).Conclusion Th

关 键 词：急性缺血性脑卒中 同型半胱氨酸 血脂 血糖 相关性 

分 类 号：R743.3[医药卫生—神经病学与精神病学]