中国卒中杂志
中國卒中雜誌
중국졸중잡지
CHINESE JOURNAL OF STROKE
2015年
4期
313-318
,共6页
脑梗死%颈动脉斑块%同型半胱氨酸%多普勒超声
腦梗死%頸動脈斑塊%同型半胱氨痠%多普勒超聲
뇌경사%경동맥반괴%동형반광안산%다보륵초성
Cerebral infarction%Carotid atherosclerosis plaque%Homocysteine%Ultrasonography
目的探讨急性脑梗死患者血清同型半胱氨酸（homocysteine，HCY）与颈动脉斑块的关系。
<br> 方法回顾性分析北京朝阳医院西区2013年6月～2014年6月神经内科住院的急性脑梗死患者196例，通过彩色多普勒超声仪测定颈动脉粥样硬化斑块的有无，测定内中膜厚度及其最大斑块厚度。在发病4 d内检测其血清HCY浓度。患者按照有无斑块分为斑块组（n=152）和无斑块组（n=44）。组间比较采用秩和检验，HCY与颈动脉斑块最大厚度的关系采用Spearman秩相关检验。颈动脉斑块形成的危险因素分析采用Logistic回归分析。
<br> 结果无斑块组（n=44）的HCY中位数是11.6μmol/L，斑块组（n=152）的HCY的中位数是14.0μmol/L，秩和检验P=0.011。Spearman相关检验发现HCY与颈动脉最大斑块厚度呈显著正相关，相关系数r=0.247， P<0.001。Logistic回归分析，发现年龄[比值比（odds ratio，OR）1.089，95%可信区间（confidence interval，CI）1.050～1.131，P=0.0001]、男性性别（OR 4.304，95%CI 1.738～10.660，P=0.002）、高血压史（OR 3.864，95%CI 1.750～8.534，P=0.001）是影响斑块形成的独立危险因素，而HCY（OR 1.026，95%CI 0.973～1.081，P=0.344）对斑块形成的影响无显著性。但是，对于非心源性脑梗死亚组（n=183）分析发现HCY是斑块形成的独立危险因素（OR 1.267，95%CI 1.006～1.430，P=0.003）。
<br> 结论对于急性脑梗死患者，斑块组血清HCY高于无斑块组，血清HCY与颈动脉最大斑块厚度呈正相关。在非心源性脑梗死患者中HCY是颈动脉斑块形成的独立危险因素。
目的探討急性腦梗死患者血清同型半胱氨痠（homocysteine，HCY）與頸動脈斑塊的關繫。
<br> 方法迴顧性分析北京朝暘醫院西區2013年6月～2014年6月神經內科住院的急性腦梗死患者196例，通過綵色多普勒超聲儀測定頸動脈粥樣硬化斑塊的有無，測定內中膜厚度及其最大斑塊厚度。在髮病4 d內檢測其血清HCY濃度。患者按照有無斑塊分為斑塊組（n=152）和無斑塊組（n=44）。組間比較採用秩和檢驗，HCY與頸動脈斑塊最大厚度的關繫採用Spearman秩相關檢驗。頸動脈斑塊形成的危險因素分析採用Logistic迴歸分析。
<br> 結果無斑塊組（n=44）的HCY中位數是11.6μmol/L，斑塊組（n=152）的HCY的中位數是14.0μmol/L，秩和檢驗P=0.011。Spearman相關檢驗髮現HCY與頸動脈最大斑塊厚度呈顯著正相關，相關繫數r=0.247， P<0.001。Logistic迴歸分析，髮現年齡[比值比（odds ratio，OR）1.089，95%可信區間（confidence interval，CI）1.050～1.131，P=0.0001]、男性性彆（OR 4.304，95%CI 1.738～10.660，P=0.002）、高血壓史（OR 3.864，95%CI 1.750～8.534，P=0.001）是影響斑塊形成的獨立危險因素，而HCY（OR 1.026，95%CI 0.973～1.081，P=0.344）對斑塊形成的影響無顯著性。但是，對于非心源性腦梗死亞組（n=183）分析髮現HCY是斑塊形成的獨立危險因素（OR 1.267，95%CI 1.006～1.430，P=0.003）。
<br> 結論對于急性腦梗死患者，斑塊組血清HCY高于無斑塊組，血清HCY與頸動脈最大斑塊厚度呈正相關。在非心源性腦梗死患者中HCY是頸動脈斑塊形成的獨立危險因素。
목적탐토급성뇌경사환자혈청동형반광안산（homocysteine，HCY）여경동맥반괴적관계。
<br> 방법회고성분석북경조양의원서구2013년6월～2014년6월신경내과주원적급성뇌경사환자196례，통과채색다보륵초성의측정경동맥죽양경화반괴적유무，측정내중막후도급기최대반괴후도。재발병4 d내검측기혈청HCY농도。환자안조유무반괴분위반괴조（n=152）화무반괴조（n=44）。조간비교채용질화검험，HCY여경동맥반괴최대후도적관계채용Spearman질상관검험。경동맥반괴형성적위험인소분석채용Logistic회귀분석。
<br> 결과무반괴조（n=44）적HCY중위수시11.6μmol/L，반괴조（n=152）적HCY적중위수시14.0μmol/L，질화검험P=0.011。Spearman상관검험발현HCY여경동맥최대반괴후도정현저정상관，상관계수r=0.247， P<0.001。Logistic회귀분석，발현년령[비치비（odds ratio，OR）1.089，95%가신구간（confidence interval，CI）1.050～1.131，P=0.0001]、남성성별（OR 4.304，95%CI 1.738～10.660，P=0.002）、고혈압사（OR 3.864，95%CI 1.750～8.534，P=0.001）시영향반괴형성적독립위험인소，이HCY（OR 1.026，95%CI 0.973～1.081，P=0.344）대반괴형성적영향무현저성。단시，대우비심원성뇌경사아조（n=183）분석발현HCY시반괴형성적독립위험인소（OR 1.267，95%CI 1.006～1.430，P=0.003）。
<br> 결론대우급성뇌경사환자，반괴조혈청HCY고우무반괴조，혈청HCY여경동맥최대반괴후도정정상관。재비심원성뇌경사환자중HCY시경동맥반괴형성적독립위험인소。
Objective To explore the relationship between serum homocysteine and carotid atherosclerosis plaque in Chinese acute cerebral infarction patients.
<br> Methods All 196 hospitalized patients with acute cerebral infarction from June 2013 to June 2014, coming from Chaoyang Hospital west campus, were retrospectively analyzed. All patients were received carotid ultrasonography screening. To all patients, maximal thickness of carotid atherosclerosis plaque (MTCAP) and serum homocysteine (HCY) were assessed. Patients were classiifed into two groups according to the presence or absence of plaque (152 cases and 44 cases, respectively).
<br> Results The median of HCY in none plaque group (n=44) and plaque group (n=152) is 11.6 μmol/L and 14.0 μmol/L, respectively, with P value 0.011 (<0.05) in Rank test. Spearman correlation test showed that there was a liner relationship between HCY and MTCAP, r=0.247, P=0.0001 (<0.05). Logistic regression revealed that age (odds ratio [OR] value 1.089, 95%conifdence interval [CI] 1.050~1.131, P=0.0001), male (OR value 4.304, 95%CI 1.738~10.660, P=0.002),?hypertension history (OR value 3.864, 95%CI 1.750~8.534, P=0.001) were independent risk factors of carotid atherosclerosis plaque, but HCY (OR value 1.026, 95%CI 0.973~1.081, P=0.344) was not. However, the analysis of none cardiac cerebral infarction subgroup (n=183) according to TOAST classification method shows that HCY is an independent risk factor of carotid atherosclerosis plaque (OR value 1.267, 95%CI 1.006~1.430, P=0.003).
<br> Conclusion For Chinese acute infarction patients, serum HCY positively correlates to maximal thickness of atherosclerosis plaque. And HCY is an independent risk factor to the presence of carotid atherosclerosis plaque in none cardiac cerebral infarction patients.
