CAJ | 학술논문

背景:越来越多的研究表明高同型巯乙胺酸(homocysteine,Hcy)是脑血管病的一个独立危险因素,控制Hcy水平对脑血管病发病率、复发率的影响是目前研究的焦点.目的:研究不同类型脑卒中血清Hcy水平与常见危险因素的关系.设计:病例对照研究.地点和对象:2003-01/2003-06北京京煤集团总医院神经内科住院急性脑血管病患者75例,男64例,女11例,年龄33～80岁,均经头颅CT或MRI确诊.选择同期门诊非心脑血管病36例患者为对照组,男29例,女7例,年龄30～70岁.干预:采用高压液相层析原理测定血清Hcy水平,用全自动生化仪测血脂、血糖.主要观察指标:观察组和对照组血清Hcy水平,血糖、血脂水平,患高血压、脑血管病史者比例.结果:血清Hcy水平脑卒中组[(18.75±1.8)μmol/L]与对照组[(12.84±2.36)μmol/L]比较(t=2.618,P＜0.05);脑梗死组[(20.59±1.78)μmol/L]与短暂性脑缺血组[(15.6±1.50)μmol/L]比较(t=2.012,P＜0.05);脑梗死组与脑出血组、短暂性脑缺血组与脑出血组间比较(P＞0.05);脑梗死组[(20.59±1.78)μmol/L]与对照组[(12.84±2.36)μmol/L]比较(t=2.872,P＜0.01);大面积(＞ 2 cm2)梗死组[(34.80±2.41)μmol/L]与一般脑梗死组[(18.79±1.62)μmol/L]比较(t=2.463,P＜0.05);有高血压组与无高血压组,高血脂组与血脂正常组,既往有脑血管病史者与无脑血管病者;有糖尿病者与无糖尿病者比较,差异均无显著性意义.结论:高Hcy是脑血管病独立危险因素,与高血压、高血脂、糖尿病关系不大,在不同类型脑血管病中,与脑梗死关系密切,Hcy增高水平可能与梗死程度有关.
배경:월래월다적연구표명고동형구을알산(homocysteine,Hcy)시뇌혈관병적일개독립위험인소,공제Hcy수평대뇌혈관병발병솔、복발솔적영향시목전연구적초점.목적:연구불동류형뇌졸중혈청Hcy수평여상견위험인소적관계.설계:병례대조연구.지점화대상:2003-01/2003-06북경경매집단총의원신경내과주원급성뇌혈관병환자75례,남64례,녀11례,년령33～80세,균경두로CT혹MRI학진.선택동기문진비심뇌혈관병36례환자위대조조,남29례,녀7례,년령30～70세.간예:채용고압액상층석원리측정혈청Hcy수평,용전자동생화의측혈지、혈당.주요관찰지표:관찰조화대조조혈청Hcy수평,혈당、혈지수평,환고혈압、뇌혈관병사자비례.결과:혈청Hcy수평뇌졸중조[(18.75±1.8)μmol/L]여대조조[(12.84±2.36)μmol/L]비교(t=2.618,P＜0.05);뇌경사조[(20.59±1.78)μmol/L]여단잠성뇌결혈조[(15.6±1.50)μmol/L]비교(t=2.012,P＜0.05);뇌경사조여뇌출혈조、단잠성뇌결혈조여뇌출혈조간비교(P＞0.05);뇌경사조[(20.59±1.78)μmol/L]여대조조[(12.84±2.36)μmol/L]비교(t=2.872,P＜0.01);대면적(＞ 2 cm2)경사조[(34.80±2.41)μmol/L]여일반뇌경사조[(18.79±1.62)μmol/L]비교(t=2.463,P＜0.05);유고혈압조여무고혈압조,고혈지조여혈지정상조,기왕유뇌혈관병사자여무뇌혈관병자;유당뇨병자여무당뇨병자비교,차이균무현저성의의.결론:고Hcy시뇌혈관병독립위험인소,여고혈압、고혈지、당뇨병관계불대,재불동류형뇌혈관병중,여뇌경사관계밀절,Hcy증고수평가능여경사정도유관.
BACKGROUND: More and more studies prove that homocysteine(Hcy) is one of the possible independent risk factors for cerebrovascular diseases (CVD) . It is a focus of today' s research to observe the effect on the morbidity and recurrence rate of CVD by controlling the Hcy level.OBJECTIVE: To observe the serum Hcy level and the relationship between the serum Hcy level and other familiar risk factors of different typed stroke.DESIGN: Case-control study.SETTING and PARTICIPANTS: Seventy-five inpatients, who were diagnosed as acute CVD by brain CT or MRI in the Neurology Department of General Hospital of Beijing Mining Group from January 2003 to June 2003,were selected. Thirty-six contemporaneous outpatients without cardio-and cerebrovascular diseases, 29 males and 7 females, aged 30 - 70 years, were selected as controls.INTERVENTION: Serum levels of Hcy were assayed with high pressure liquid chromatograph, and levels of blood lipid and sugar were measured with fully automatic biochemical instrument.MAIN OUTCOME MEASURES: Levels of serum Hcy, blood lipid and sugar in the two groups.RESULTS: The levels of serum Hcy were(18. 75 ± 1.8) μmol/L for the stroke group and (12. 84 ±2.36) μmol/L for the control group with significant difference( t = 2. 618, P ＜ 0.05) . The CI group[ (20. 59 ± 1.78)μ mol/L]and TIA group[ (15.6 ± 1.50)μmol/L] ( t = 2. 012, P ＜ 0. 05),but not between the CI and cerebral hemorrhage group, between TIA and cerebral hemorrhage groups( P ＞ 0.05) . The CI group and control group ( t = 2. 872, P ＜ 0.01 ), and between the large CI group[ (34.80 ± 2.41 ]μ mol/L] and the general CI group[ (18. 79 ± 1.62) μmol/L] ( t =2. 463,P ＜ 0. 05). No significant differences were found between the patients with and without hypertension, between the patients with and without hyperlipemia, between the patients with and without CVD history, and between the patients with and without DM.CONCLUSION: High level of Hcy is one of the independent risk factors for CVD, and has no relation with hypertension, hyperlipemia and diabetes. However, the Hcy level is closely related with CI for the different CVD, and the increase in the level of Hcy may be associated with the degree of CI.