短暂性脑缺血发作患者血清同型半胱氨酸、D-二聚体、脂蛋白a水平与预后的关系分析  

Relationship between serum homocysteine,D-dimer and lipoprotein a levels and the prognosis in patients with transient ischemic attack

作　　者：周丹丹 王宗立[1] 邢小飞[2] Zhou Dandan;Wang Zongli;Xing Xiaofei(Clinical laboratory Department,The 2nd People's Hospital of Zhengzhou,Zhengzhou,Henan 450000,China;Clinical laboratory Department,The 7th People's Hospital of Zhengzhou,Zhengzhou,Henan 450000,China)

机构地区：[1]郑州市第二人民医院检验科,河南郑州450000 [2]郑州市第七人民医院检验科,河南郑州450000

出　　处：《感染、炎症、修复》2024年第4期288-291,共4页Infection Inflammation Repair

摘　　要：目的:探讨短暂性脑缺血发作(TIA)患者血清同型半胱氨酸(Hcy)、D-二聚体(D-D)、脂蛋白a水平与预后的关系。方法:回顾性选取2021年1月至2024年1月郑州市第二人民医院接诊的TIA患者87例(研究组)和同期体检的健康志愿者35例(对照组)的临床资料。比较研究组和对照组血清Hcy、D-D、脂蛋白a水平,依据基于年龄、血压、症状、糖尿病+症状持续时间等制定的卒中风险评估工具(ABCD~3-I)评分将研究组患者分为低危(0~3分)、中危(4~7分)和高危(8~13分),随访半年,依据患者预后情况分为预后不良组(再发TIA、脑卒中或因病死亡)和预后良好组。分析不同危险分层患者血清Hcy、D-D、脂蛋白a水平,用单因素分析和多因素Logistic回归方法分析TIA预后独立危险因素。结果:研究组Hcy、D-D、脂蛋白a水平均明显高于对照组(P<0.05)。研究组高危、中危及低危患者Hcy、D-D、脂蛋白a水平依次明显降低,组间两两比较差异有统计学意义(P<0.05)。预后不良组总胆固醇、甘油三酯、低密度脂蛋白胆固醇、Hcy、D-D、脂蛋白a水平高于预后良好组,高密度脂蛋白胆固醇低于预后良好组(P<0.05)。Logistic回归分析显示,Hcy、D-D、脂蛋白a是影响TIA患者预后的独立危险因素(P<0.05)。结论:TIA患者血清Hcy、D-D、脂蛋白a呈明显的高表达,三者均与患者的病情程度、预后存在密切关联。Objective:To investigate the relationship between serum homocysteine(Hcy),D-dimer(D-D)and lipoprotein a levels and the prognosis in patients with transient ischemic attack(TIA).Methods:A total of 87 TIA patients(study group)and 35 healthy volunteers(control group)who underwent physical examination during the same period in the Second People's Hospital of Zhengzhou from January 2021 to January 2024 were retrospectively selected.Serum Hcy,D-D and lipoprotein a levels were compared between the study group and control group.Patients in the study group were classified as low-risk(0-3),medium-risk(4-7),and high-risk(8-13)according to the Stroke Risk Assessment Tool(ABCD~3-I)scores developed on the basis of age,blood pressure,symptoms,diabetes mellitus+symptom duration.The patients were followed up for six months and divided into a poor prognosis group(recurrent TIA,stroke,or death due to illness)and a good prognosis group based on their prognosis.Serum Hcy,D-D and lipoprotein a levels in patients with different risks stratification were analyzed.Univariate analysis and multivariate Logistic regression were used to analyze the prognostic risk factors of TIA.Results:The levels of Hcy,D-D and lipoprotein a in the study group were significantly higher than those in the control group(P<0.05).The levels of Hcy,D-D and lipoprotein a in the high-risk group,the medium-risk group,and the low-risk group decreased in sequence.There were significant differences between any two groups(P<0.05).Total cholesterol,triglyceride,low density lipoprotein cholesterol,Hcy,D-D,and lipoprotein a levels in the poor prognosis group were higher than those in the good prognosis group,and the level of high density lipoprotein cholesterol was lower than those in the good prognosis group(P<0.05).Logistic regression analysis showed that Hcy,D-D,and lipoprotein a were independent risk factors affecting the prognosis of TIA patients(P<0.05).Conclusions:Serum Hcy,D-D,and lipoprotein a levels in patients with TIA are significantly highly-expressed,which ar

关 键 词：短暂性脑缺血发作 同型半胱氨酸 D-二聚体 脂蛋白A 预后 

分 类 号：R743.31[医药卫生—神经病学与精神病学]