CAJ | 학술논문

目的：探讨高同型半胱氨酸血症(Hhcy)与老年脑梗死的关系及其可行的干预办法。方法：对60例老年脑梗死患者的血浆同型半胱氨酸(Hcy)、叶酸、维生素B12、低密度脂蛋白胆固醇、收缩压、舒张压等指标进行检测，与同期门诊54例健康体检者进行对照。结果：老年脑梗死患者血浆Hcy水平(20.25±16.99)μmol/L、LDL-C水平(3.28±0.48)mmol/L，对照组血浆 Hcy 水平(10.13±3.11)μmol/L、LDL-C 水平(2.56±0.42)mmol/L，老年脑梗死患者血浆Hcy、LDL-C水平显著高于对照组，差异有统计学意义(P＜0.01)；男性患者血浆Hcy水平(23.65±20.40)μmol/L高于女性患者血浆Hcy水平(14.38±4.56)μmol/L，差异有统计学意义(P＜0.05)。通过计算各项指标的危险度比，发现同型半胱氨酸、叶酸、维生素 B12、低密度脂蛋白胆固醇、收缩压、舒张压是与脑梗死发病危险性有关的因素，条件Logistic 回归模型检验 Hcy、LDL-C、SBP 为脑梗死独立危险因素(Hcy OR 1.351，95%CI 1.111～1.641)。研究组血浆Hcy 水平与叶酸(r-0.679，P＜0.01)、维生素 B12(r-0.587，P＜0.01)的相关性为负相关；对照组血浆 Hcy 水平与叶酸(r-0.775，P＜0.01)、维生素B12(r-0.667，P＜0.01)的相关性为负相关，差异均有统计学意义。结论： Hhcy是老年脑梗死的独立危险因素，且在脑梗死组中Hcy水平存在性别差异，女性低于男性，血浆叶酸和维生素B12的降低可能是导致Hhcy的原因。
목적：탐토고동형반광안산혈증(Hhcy)여노년뇌경사적관계급기가행적간예판법。방법：대60례노년뇌경사환자적혈장동형반광안산(Hcy)、협산、유생소B12、저밀도지단백담고순、수축압、서장압등지표진행검측，여동기문진54례건강체검자진행대조。결과：노년뇌경사환자혈장Hcy수평(20.25±16.99)μmol/L、LDL-C수평(3.28±0.48)mmol/L，대조조혈장 Hcy 수평(10.13±3.11)μmol/L、LDL-C 수평(2.56±0.42)mmol/L，노년뇌경사환자혈장Hcy、LDL-C수평현저고우대조조，차이유통계학의의(P＜0.01)；남성환자혈장Hcy수평(23.65±20.40)μmol/L고우녀성환자혈장Hcy수평(14.38±4.56)μmol/L，차이유통계학의의(P＜0.05)。통과계산각항지표적위험도비，발현동형반광안산、협산、유생소 B12、저밀도지단백담고순、수축압、서장압시여뇌경사발병위험성유관적인소，조건Logistic 회귀모형검험 Hcy、LDL-C、SBP 위뇌경사독립위험인소(Hcy OR 1.351，95%CI 1.111～1.641)。연구조혈장Hcy 수평여협산(r-0.679，P＜0.01)、유생소 B12(r-0.587，P＜0.01)적상관성위부상관；대조조혈장 Hcy 수평여협산(r-0.775，P＜0.01)、유생소B12(r-0.667，P＜0.01)적상관성위부상관，차이균유통계학의의。결론： Hhcy시노년뇌경사적독립위험인소，차재뇌경사조중Hcy수평존재성별차이，녀성저우남성，혈장협산화유생소B12적강저가능시도치Hhcy적원인。
Objective:To investigate the correlation between hyperhomocysteinemia(Hhcy) and senile cerebral infarction and feasible intervention.Methods:Plasma homocysteine(Hcy),folic acid,vitamin B12,low density lipoprotein cholesterol,systolic pressure and diastolic pressure were tested and compared in 60 elderly patients with cerebral infarction and 54 healthy control cases.Results:The plasma Hcy level and the level of LDL-C in elderly patients with cerebral infarction were(20.25±16.99)umol/L and(3.28±0.48)mmol/L,and in the control group those were(10.13±3.11)umol/L and(2.56±0.42)mmol/L respectively;Hcy and LDL-C plasma levels in elderly patients with cerebral infarction were significantly higher when compared with the control group, and the difference were statistically signifcant(P<0.01);Plasma Hcy levels in male patients(23.65±20.40umol/L) was higher than that in female patients(14.38 ± 4.56umol/L),with significantly difference(P<0.05).The calculated risk ratio showed that homocysteine,folic acid,vitamin B12,low density lipoprotein cholesterol,systolic pressure and diastolic pressure were risk factors for cerebral infarction.Conditional logistic regression model demonstrated that Hcy,LDL-C,SBP were the independent risk factors for cerebral infarction(Hcy OR 1.351,95%CI 1.111~1.641).There was a negative correlation between the level of plasma Hcy and folic acid(r=-0.679, P<0.01) and VitB12(r=-0.587,P<0.01);the same results existed in the control group that the folic acid(r=-0.775,P<0.01),VitB12(r=-0.667,P<0.01),and the differences were statistically significant in both groups.Conclusion:Hhcy is an independent risk factor for senile cerebral infarction,and the Hcy level display gender differences in the cerebral infarction group,lower in women than in men.Lower plasma folate and vitamin B12 may cause Hhcy.