CAJ | 학술논문

目的探讨高同型半胱氨酸(Hcy)、高纤维蛋白原(Fib)等对Binswanger病(BD)脑白质疏松(LA)严重程度的影响.方法对自2005年1月1日至2011年5月9日在中山大学附属第三医院住院且确诊为BD的患者进行血清Hcy、Fib、低密度脂蛋白(LDL)、载脂蛋白A(Apoa)、载脂蛋白B(Apob)、高密度脂蛋白(HDL)检测,并将BD患者按LA头颅MRI表现严重程度分为轻、中、重3型,单因素分析及有序Logistic回归法分析Fib、Hcy等因素与LA严重程度的关系.结果单因素分析结果显示:LA不同严重程度组间性别、年龄、高血压病、卒中史、高脂血症比较差异有统计学意义(P＜0.05).LA严重程度与Hcy、Fib存在正向的等级相关关系(P＜0.05).有序Logistic回归分析结果显示:女性LA程度比男性更严重;年龄越大,有卒中史和Fib测定值越大,LA程度更严重(P＜0.05).结论 Fib水平是BD恶化的一个重要因素,降低Fib水平可能对延缓BD病情进展有效.
목적 탐토고동형반광안산(Hcy)、고섬유단백원(Fib)등대Binswanger병(BD)뇌백질소송(LA)엄중정도적영향.방법 대자2005년1월1일지2011년5월9일재중산대학부속제삼의원주원차학진위BD적환자진행혈청Hcy、Fib、저밀도지단백(LDL)、재지단백A(Apoa)、재지단백B(Apob)、고밀도지단백(HDL)검측,병장BD환자안LA두로MRI표현엄중정도분위경、중、중3형,단인소분석급유서Logistic회귀법분석Fib、Hcy등인소여LA엄중정도적관계.결과 단인소분석결과현시:LA불동엄중정도조간성별、년령、고혈압병、졸중사、고지혈증비교차이유통계학의의(P＜0.05).LA엄중정도여Hcy、Fib존재정향적등급상관관계(P＜0.05).유서Logistic회귀분석결과현시:녀성LA정도비남성경엄중;년령월대,유졸중사화Fib측정치월대,LA정도경엄중(P＜0.05).결론 Fib수평시BD악화적일개중요인소,강저Fib수평가능대연완BD병정진전유효.
Objective To investigate the correlation between severity of leukoaraiosis (LA) and plasma levels of homocysteine and fibrinogen in patients with Binswanger disease (BD).Methods All patients with BD,admitted to our hospital from January 2005 to May 2011,were selected consistently with the diagnostic criteria of Bennett.The levels of plasma homocysteine (Hcy),fibrinogen (Hcy),low-density lipoprotein (LDL),apolipoprotein A (Apoa),apolipoprotein B (Apob),and high-density lipoprotein (HDL) were measured.According to the Kinkel's classification of BD,the severity of LA was graded as mild,moderate,or severe by its appearance under MRI.The relation between levels of plasma Hcy and Fib and severity of LA in BD patients were analyzed.Results Single factor analysis indicated that the dispositions of gender,age,hypertensive disease,stroke and hyperlipoidemia in BD patients with different severities of LA were significantly different (P＜0.05).The severity degree of LA was positively correlated with the levels of Hcy and Fib (P＜0.05).Ordered logistic regression analysis showed that female was severer than male in the severity of the LA in BD patients; age,stroke and level of plasma Fib were positively related to the severity of LA in BD patients (P＜0.05).Conclusion The high plasma level of Fib is an important factor for BD deterioration; reducing the level of plasma Fib may delay the aggravation of BD.