摘要
目的探讨伴有高同型半胱氨酸(Hcy)血症的高血压(H型高血压)与急性脑梗死患者颅内外动脉中-重度狭窄的关系。方法回顾性连续纳入2013年1月至2015年10月于胜利油田中心医院神经内科住院的425例经全脑DSA检查的急性脑梗死患者,记录所有患者的脑血管病常规危险因素及实验室指标。根据DSA结果分为颅内外动脉中-重度狭窄(狭窄率≥50%)组(狭窄组,273例)和无狭窄组(152例),比较两组间一般资料及实验室指标的差异。以合并颅内外动脉中-重度狭窄为因变量,将单因素分析差异有统计学意义的指标作为自变量纳入多因素Logistics回归模型分析。进一步依据是否有高血压病和高Hcy水平,将患者分为正常组38例、单纯高血压组86例、单纯高Hcy组92例和H型高血压组209例,比较H型高血压组与其余3组之间颅内外动脉中-重度狭窄的差异。结果 (1)与无狭窄组比较,狭窄组吸烟、糖尿病、高血压病、H型高血压、高Hcy患者比率更高,Hcy水平较高,差异均有统计学意义(均P<0.05),其余危险因素间差异无统计学意义(均P>0.05)。(2)多因素Logistic回归分析显示H型高血压(OR=2.769,95%CI:1.071～7.158)、糖尿病(OR=2.360,95%CI:1.441～3.867)、吸烟(OR=1.605,95%CI:1.056～2.439)是发生颅内外动脉中-重度狭窄的独立危险因素。(3)H型高血压组颅内外动脉中-重度狭窄发生率为74.6%(156/209),明显高于单纯高血压组[57.0%(49/86)]、正常组[55.3%(21/38)]及单纯高Hcy组[51.1%(47/92)],差异有统计学意义(P<0.01)。结论 H型高血压、合并糖尿病、吸烟是急性脑梗死患者颅内外动脉中-重度狭窄的独立危险因素,并且H型高血压较高血压病患者的颅内外动脉中-重度狭窄发生率更高。
Objective To investigate the correlation between hypertension associated with hyperhomocysteinemia（ Hcy）（ H-type hypertension） and moderate to severe stenosis of extra-and intracranial arteries in patients with acute cerebral infarction. Methods From January 2013 to October 2015,425 consecutive patients with acute cerebral infarction admitted to the Department of Neurology,Shengli Oilfield Central Hospital and examined with whole brain DSA were enrolled retrospectively. All patients with routine risk factors for cerebrovascular disease and laboratory indicators were recorded. According to the DSA findings,the patients were divided into extra-and intracranial arterial moderate to severe stenosis（ the incidence of stenosis ≥50%） group（ stenosis group,n = 273） and non-stenosis group（ n = 152）. The differences in the general data and the laboratory indexes between the two groups were compared. Combined with extra-and intracranial moderate to severe arterial stenosis as a dependent variable,univariate analysis showed that the statistically significant index was an independent variable and was introduced into a multivariate Logistic regression model. Further based on whether having hypertension and Hcy level,the patients were divided into normal group（ n = 38）,simple hypertension group（ n = 86）,simple high-Hcy group（ n = 92）,and H-type hypertension group（ n = 209）. The differences of extra-and intracranial moderate to severe arterial stenosis between the H-type hypertension group and the other three groups w ere com pared.Results（ 1） Compared with the non-stenosis group,the patient ratio of smoking,diabetes,hypertension,H-type hypertensive patients,and high Hcy were higher in stenosis group,and the level of Hcy was higher too,the differences were statistically significant（ all P〈0. 05）. There were no significant differences among the other risk factors（ all P〉0. 05）.（ 2） Multivariate Logistic regression analysis indicated that H-type hypertension（ OR,2. 769,95
作者
唐天萍
高宗恩
陈晓辉
钟孟飞
吕在刚
李海停
Tang Tianping;Gao Zongen;Chen Xiaohui;Zhong Mengfei;Lyu Zaigang;Li Haiting(Department of Neurology,Shengli Oilfield Central Hospital,257031 Dongying,China)
出处
《中国脑血管病杂志》
CAS
CSCD
北大核心
2018年第10期530-533,共4页
Chinese Journal of Cerebrovascular Diseases
关键词
H型高血压
急性脑梗死
颅内外动脉狭窄
H-type hypertension
Acute cerebral infarction
Extra and intracranial arterial stenosis
