中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2012年
19期
2908-2910
,共3页
薛敏%马云辉%张梅%余传庆
薛敏%馬雲輝%張梅%餘傳慶
설민%마운휘%장매%여전경
脑梗死%同型半胱氨酸%载脂蛋白%血管疾病
腦梗死%同型半胱氨痠%載脂蛋白%血管疾病
뇌경사%동형반광안산%재지단백%혈관질병
Cerebral infarction%Hyperhomocysteinemia%Apolipoprolion%Vascular Diseases
目的 探讨脑梗死患者血清同型半胱氨酸( Hcy)水平、载脂蛋白B(ApoB)/载脂蛋白A1(ApoAl)比值与颅内外血管狭窄的相关性.方法 对行数字减影血管造影术(DSA)检查的184例脑梗死患者进行分组,颅内外血管狭窄组(狭窄组)158例、颅内外血管正常组(对照组)26例；按狭窄部位又将狭窄组分为单纯颅内血管狭窄组48例(颅内组)、单纯颅外血管狭窄组60例(颅外组)及颅内外血管狭窄组50例(颅内外组).检测血浆Hcy与载脂蛋白A1、载脂蛋白B水平,并计算比值,比较其与颅内外血管狭窄的相关性.结果 (1)狭窄组血清Hcy、ApoB、ApoB/ApoAl值和高Hcy发生率分别为(16.9±8.1) μmol/L、( 1.02±0.25)g/L、(0.94±0.50)g/L、40％,对照组分别为(8.6±4.6) μmol/L、(0.86±0.22) g/L、(0.64±0.21) g/L和0,两组差异均有统计学意义(P＜0.01).(2)颅内组、颅外组、颅内外组血清Hcy、ApoB/ApoA1水平组间差异无统计学意义.(3)多元逐步Logistic回归分析发现,血清Hcy水平升高(OR=1.146,95％ CI:1.021 ～1.287；P =0.021),ApoB/ApoA1比值升高(OR =4.71,95％ CI为1.70～14.20,P=0.005),ApoB水平升高(OR=4.50,95％ CI为1.62 ～12.80,P=0.007),HDL降低(OR =0.089,95CI:0.014 ～0.551.P=0.017),Cho水平升高(OR =2.406;95％ CI:1.145 ～5.055:P=0.023)是颅内外血管狭窄的危险因素.结论 血清同型半胱氨酸水平升高及载脂蛋白B与载脂蛋白A1比值水平升高是颅内外血管狭窄的危险因素.
目的 探討腦梗死患者血清同型半胱氨痠( Hcy)水平、載脂蛋白B(ApoB)/載脂蛋白A1(ApoAl)比值與顱內外血管狹窄的相關性.方法 對行數字減影血管造影術(DSA)檢查的184例腦梗死患者進行分組,顱內外血管狹窄組(狹窄組)158例、顱內外血管正常組(對照組)26例；按狹窄部位又將狹窄組分為單純顱內血管狹窄組48例(顱內組)、單純顱外血管狹窄組60例(顱外組)及顱內外血管狹窄組50例(顱內外組).檢測血漿Hcy與載脂蛋白A1、載脂蛋白B水平,併計算比值,比較其與顱內外血管狹窄的相關性.結果 (1)狹窄組血清Hcy、ApoB、ApoB/ApoAl值和高Hcy髮生率分彆為(16.9±8.1) μmol/L、( 1.02±0.25)g/L、(0.94±0.50)g/L、40％,對照組分彆為(8.6±4.6) μmol/L、(0.86±0.22) g/L、(0.64±0.21) g/L和0,兩組差異均有統計學意義(P＜0.01).(2)顱內組、顱外組、顱內外組血清Hcy、ApoB/ApoA1水平組間差異無統計學意義.(3)多元逐步Logistic迴歸分析髮現,血清Hcy水平升高(OR=1.146,95％ CI:1.021 ～1.287；P =0.021),ApoB/ApoA1比值升高(OR =4.71,95％ CI為1.70～14.20,P=0.005),ApoB水平升高(OR=4.50,95％ CI為1.62 ～12.80,P=0.007),HDL降低(OR =0.089,95CI:0.014 ～0.551.P=0.017),Cho水平升高(OR =2.406;95％ CI:1.145 ～5.055:P=0.023)是顱內外血管狹窄的危險因素.結論 血清同型半胱氨痠水平升高及載脂蛋白B與載脂蛋白A1比值水平升高是顱內外血管狹窄的危險因素.
목적 탐토뇌경사환자혈청동형반광안산( Hcy)수평、재지단백B(ApoB)/재지단백A1(ApoAl)비치여로내외혈관협착적상관성.방법 대행수자감영혈관조영술(DSA)검사적184례뇌경사환자진행분조,로내외혈관협착조(협착조)158례、로내외혈관정상조(대조조)26례；안협착부위우장협착조분위단순로내혈관협착조48례(로내조)、단순로외혈관협착조60례(로외조)급로내외혈관협착조50례(로내외조).검측혈장Hcy여재지단백A1、재지단백B수평,병계산비치,비교기여로내외혈관협착적상관성.결과 (1)협착조혈청Hcy、ApoB、ApoB/ApoAl치화고Hcy발생솔분별위(16.9±8.1) μmol/L、( 1.02±0.25)g/L、(0.94±0.50)g/L、40％,대조조분별위(8.6±4.6) μmol/L、(0.86±0.22) g/L、(0.64±0.21) g/L화0,량조차이균유통계학의의(P＜0.01).(2)로내조、로외조、로내외조혈청Hcy、ApoB/ApoA1수평조간차이무통계학의의.(3)다원축보Logistic회귀분석발현,혈청Hcy수평승고(OR=1.146,95％ CI:1.021 ～1.287；P =0.021),ApoB/ApoA1비치승고(OR =4.71,95％ CI위1.70～14.20,P=0.005),ApoB수평승고(OR=4.50,95％ CI위1.62 ～12.80,P=0.007),HDL강저(OR =0.089,95CI:0.014 ～0.551.P=0.017),Cho수평승고(OR =2.406;95％ CI:1.145 ～5.055:P=0.023)시로내외혈관협착적위험인소.결론 혈청동형반광안산수평승고급재지단백B여재지단백A1비치수평승고시로내외혈관협착적위험인소.
Objective To investigate the correlation of the plasma homocysteine level and serum B/apolipoprolionAl(ApoB/ApoAl) radio with cerebral vascular stenosis in patients with cerebral infarction.Methods 184 patients with cerebral infarction experienced cerebral digital substraction angiography (DSA) were selected.Among them,158 patients with cerebrovascular stenesis and 26 patients without stenosis were included.Three groups were categorized by distribution of artery lesion sites:isolated intracranial artery stenesis ( n =48 ),isolated extracranial artery stenosis( n =60) co-existing of intracranial and extracranial artery stenosis( n =50).The correlation analysis was made between the levels of Hcy and ApoB/ApoAl with cerebral vascular stenosis in patients with cerebral infarction.Results ( 1 ) The proportion of subjects with high level of plasma homocysteine was significantly higher in patients with cerebrovascular stenosis than those without[( 16.9 ±8.1 ) μmol/L vs (8.6 ±4.6) μmol/L,P ＜0.001 ;40％ vs 0,P ＜0.01].The proportion of subjects with high level of ApoB and ApoB/ApoA1 ratio was significantly higher in patients with cerebrovascular stenosis than those without ApoB [( 1.02 ± 0.25 ) vs ( 0.86 ± 0.22 ) g/L,P ＜ 0.01],ApoB/ApoAl ratio [( 0.94 ± 0.50) vs ( 0.64 ± 0.21,P ＜ 0.01 )].(2) For the different groups of artery lesion sites,the proportion of subjects with high level of plasma homocysteine was not significantly different[( 16.1 ± 8.5 )mml/L、( 17.0 ± 8.9 ) mmol/L、( 16.7 ± 8.7 ) mmol/L,P ＞ 0.05],the proportion of subjects with ApoB/ApoAl ratio was not significantly different [0.98 ± 0.45,0.93 ± 0.48,0.96 + 0.50,P ＞ 0.05].(3) Based on multivariable stepwise Logistic regression model,the increased level of Hcy( OR =1.146,95％ CI:1.021 ～ 1.287 ;P =0.021 ),the increased level of ApoB/ApoAl ( OR =4.71,95 ％ CI:1.70 ～ 14.20,P =0.005 ),the increased level of ApoB ( OR =4.50,95 ％ CI 为 1.62 ～ 12.80,P =0.007),the increased level of Cho ( OR =2.406 ;95％ CI:1.145 ～ 5.055 ; P =0.023 ),the decresed level of HDL( OR =0.089,95％ CI:0.014 ～ 0.551,P =0.017 ) were all risk factors.Conclusion High level of plasma homocysteine and ApoB/ApoAl were both independent risk factors for cerebral vascular stenosis.
