首页|血清同型半胱氨酸水平对脑小血管病总负荷的影响

血清同型半胱氨酸水平对脑小血管病总负荷的影响

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目的 观察脑小血管病(cerebral small vessel disease，CSVD)总负荷的影响因素及血清同型半胱氨酸(Homocysteine，Hcy)水平与CSVD总负荷的相关性。方法 选取 2018 年 1 月～2022 年 11 月承德市中心医院神经内科确诊的CSVD患者242 例，根据CSVD 总负荷评分进行分组，0～2 分为低负荷组，3～4 分为高负荷组。比较两组患者一般人口学资料、合并症、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FPG)、红细胞沉降率(ESR)、尿酸(UA)、肌酐(Cr)、Hcy水平，分析影响CSVD 总负荷的风险因素，使用Spearman相关分析Hcy水平与CSVD总负荷的相关性。结果 低负荷组共 115 例，高负荷组共 127 例。高负荷组年龄、TC、LDL-C、UA、Hcy水平均高于低负荷组[(66。81±10。23)岁vs。(60。28±11。40)岁、(4。96±1。18)mmol/L vs。(4。54±1。02)mmol/L、(3。36±0。97)mmol/L vs。(3。04±1。01)mmol/L、(308。84±48。61)μmol/L vs。(292。79±50。04)μmol/L、(14。78±3。91)μmol/L vs。(13。64±4。04)μmol/L]，高血压、动脉粥样硬化占比均高于低负荷组[(79。53%vs。50。43%)、(72。44%vs。53。04%)]，组间差异有统计学意义(t=4。696、2。948、2。513、2。529、2。229，χ2=22。667、9。766，P<0。05)。多因素分析显示高龄、合并高血压、动脉粥样硬化、LDL-C、Hcy水平升高为 CSVD总负荷增加的独立危险因素(P<0。05)。Hcy 水平与 CSVD 总负荷呈弱正相关(r= 0。028，P=0。013)。结论 年龄、高血压、动脉粥样硬化、脂代谢异常等多种因素可影响CSVD总负荷，关注Hcy水平，早期干预可能优化CSVD的防治方案。
The effect of serum homocysteine level on the total load of cerebrovascular disease
Objective To investigate the influencing factors of total load in cerebral small vessel disease(CSVD)and the correlation between serum Hcy level and total load in CSVD.Methods A total of 242 patients diagnosed with CSVD by the neurology department in our hospital were categorized into two groups based on the total load score of CSVD,those with scores of 0～2 were placed in the low load group,while those with scores of 3～4 were placed in the high load group.General demographic data,comorbidities,TC,TG,LDL-C,HDL-C,FPG,ESR,UA,Cr,and Hcy levels of the two groups were compared to analyze the risk factors affecting the total load of CSVD.The Spearman correlation was used to analyze the association between Hcy levels and the total load of CSVD.Results There were 115 cases in the low load group and 127 cases in the high load group.The age,TC,LDL-C,UA,Hcy levels in the high load group were higher than those in the low load group,while the proportions of hypertension and atherosclerosis were higher than those in the low load group.The difference between the groups was statistically significant(t=4.696,2.948,2.513,2.529,2.229,χ2=22.667,9.766,P<0.05).Multivariate analysis showed that old age,hypertension,atherosclerosis,elevated levels of LDL-C and Hcy were independent risk factors for the increase of the total load of CSVD(P<0.05).The level of Hcy was slightly positively correlated with the total load of CSVD(r = 0.028,P = 0.013).Conclusion Factors like age,hypertension,atherosclerosis,abnormal lipid metabolism and others can affect the total load of CSVD.It is important to monitor Hcy levels,as early intervention may optimize the prevention and treatment of CSVD.

Cerebrovascular diseaseHomocysteineTotal magnetic resonance loadInfluencing factors

崔瑜、张沐源、孟清丽、高欢、杨成程、郑义

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067000 承德市中心医院放射医学影像科

脑小血管病 同型半胱氨酸 核磁总负荷 影响因素

承德市科学技术研究项目

201903A010

2024

10.3969/j.issn.1674-3245.2024.01.011

中华保健医学杂志
中国人民解放军总后勤部卫生部保健局

中华保健医学杂志

CSTPCD
影响因子：0.477
ISSN：1674-3245
年,卷(期)：2024.26(1)
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