CAJ | 학술논문

目的：探讨同型半胱氨酸（ Hcy）水平与青年脑梗死患者颈动脉硬化的相关性，为降低青年脑梗死的发病率提供新的思路。方法对2007年1月至2013年12月入住东南大学附属中大医院神经内科的18～45周岁脑梗死患者的临床资料进行回顾性分析。通过颈动脉彩色多普勒超声检查，将入组的患者分为颈动脉硬化组、无颈动脉硬化组。比较两组患者的基本特征以及Hcy水平。计量资料用均数±标准差（ x珋±s）表示，若数据服从正态性分布，组间差异显著性直接采用独立两样本t检验，若数据不服从正态性分布，则将数据先经过对数转化再进行独立两样本t检验。计数资料用频率表示，采用χ2检验。利用二分类Logistic回归分析校正非研究因素后，分析Hcy水平对颈动脉硬化的影响。 P＜0.05为差异有统计学意义。结果研究共入选了104例研究对象，其中无动脉硬化组58例，动脉硬化组46例。两组在年龄、性别、吸烟、饮酒、高密度脂蛋白水平、甘油三酯水平、总胆固醇水平等方面差异无统计学意义（ P ＞0.05），在高血压病史（χ2＝5.273， P ＝0.022）、糖尿病史（χ2＝5.188，P＝0.023）、低密度脂蛋白水平（t＝2.505，P＝0.014）及Hcy水平（t＝3.580，P＝0.001）方面差异具有统计学意义，颈动脉硬化组的Hcy水平高于无颈动脉硬化组。二分类Logistic回归分析显示，血Hcy浓度的升高，增加颈动脉硬化的形成（β＝0.095，P＝0.004）。结论我们的研究结果提示在青年脑梗死患者中高Hcy水平可以促进颈动脉硬化形成，这种影响独立于传统的危险因素。
목적：탐토동형반광안산（ Hcy）수평여청년뇌경사환자경동맥경화적상관성，위강저청년뇌경사적발병솔제공신적사로。방법대2007년1월지2013년12월입주동남대학부속중대의원신경내과적18～45주세뇌경사환자적림상자료진행회고성분석。통과경동맥채색다보륵초성검사，장입조적환자분위경동맥경화조、무경동맥경화조。비교량조환자적기본특정이급Hcy수평。계량자료용균수±표준차（ x류±s）표시，약수거복종정태성분포，조간차이현저성직접채용독립량양본t검험，약수거불복종정태성분포，칙장수거선경과대수전화재진행독립량양본t검험。계수자료용빈솔표시，채용χ2검험。이용이분류Logistic회귀분석교정비연구인소후，분석Hcy수평대경동맥경화적영향。 P＜0.05위차이유통계학의의。결과연구공입선료104례연구대상，기중무동맥경화조58례，동맥경화조46례。량조재년령、성별、흡연、음주、고밀도지단백수평、감유삼지수평、총담고순수평등방면차이무통계학의의（ P ＞0.05），재고혈압병사（χ2＝5.273， P ＝0.022）、당뇨병사（χ2＝5.188，P＝0.023）、저밀도지단백수평（t＝2.505，P＝0.014）급Hcy수평（t＝3.580，P＝0.001）방면차이구유통계학의의，경동맥경화조적Hcy수평고우무경동맥경화조。이분류Logistic회귀분석현시，혈Hcy농도적승고，증가경동맥경화적형성（β＝0.095，P＝0.004）。결론아문적연구결과제시재청년뇌경사환자중고Hcy수평가이촉진경동맥경화형성，저충영향독립우전통적위험인소。
Objective To explore the association between homocysteine ( Hcy ) concentration and carotid atherosclerosis in young cerebral infarction patients ,providing new ideas for reducing the incidence of young cerebral infarction .Methods A retrospective analysis of data from patients aged 18 to 45 years consecutively treated for cerebral infarction in a neurology unit between January 2007 and December 2013 was performed .We graded carotid atherosclerosis using carotid duplex as:no atherosclerosis group and atherosclerosis group .Baseline characteristics and plasma levels of Hcy of these two groups were analyzed . The measurement data were presented as xˉ±s, if the data were distributed in a normal fashion , two independent samples t test was used to compare the differences between groups ,and if the data were in an abnormal distribution , a logarithmic transformation would be done before two independent samples t test. Count data were presented as Frequency ,and using χ2 test.Then binary logistic regression was used to adjust non study variables ,and the effect of Hcy on carotid artery atherosclerosis was analyzed .A level of P<0.05 was considered as statistical significance .Results One hundred and four patients were included:58 in no atherosclerosis group and 46 in atherosclerosis group.The difference of age,sex,smoking,drinking,high-density lipoprotein cholesterol ,triglycerides and total cholesterol was not significant between these two groups ( P>0.05 ) ,whereas hypertension (χ2 =5.273 , P=0.022 ) , diabetes (χ2 =5.188 , P=0.023 ) , low-density lipoprotein cholesterol ( t =2.505 , P =0.014 ) and Hcy ( t =3.580 , P=0.001 ) were significant different . Atherosclerosis group′s Hcy concentration was significantly higher than those in no atherosclerosis group . Binary logistic regression showed that , higher Hcy concentration in the blood can increase the formation of carotid atherosclerosis (β=0.095 , P =0.004 ) .Conclusion Our results show that high Hcy level can promote the formation of carotid atherosclerosis in young adults with cerebral infarction .This effect is independent of traditional risk factors .