摘要
目的 探讨血清同型半胱氨酸(Hcy)及糖化血红蛋白(HbA1c)水平与急性脑梗死(ACI)患者颈动脉硬化的关系,为后期二级预防提供依据。方法 连续纳入TOAST分型为大动脉粥样硬化型(LAA)和小动脉闭塞型(SAO)的ACI患者共236例,根据颈部血管超声检查结果分为:无斑块组、稳定斑块组、不稳定斑块组及狭窄组,检测并分析比较各组血清Hcy和HbA1c等指标的水平差异。采用多因素Logistic回归分析颈动脉硬化的危险因素。结果 ①年龄、三酰甘油、低密度脂蛋白、Hcy、HbA1c、高血压病史、吸烟、饮酒、TOAST分型在不同颈动脉硬化组间差异有统计学意义(P<0.05);②多因素Logistic回归分析显示:血清Hcy和HbA1c水平升高是ACI患者颈动脉硬化发生发展的危险因素(OR值分别为3.157、0.451,95%CI分别为1.489~6.381、0.167~1.281;P值分别为0.019、0.045)。结论 血清Hcy和HbA1c水平升高是LAA型和SAO型ACI患者颈动脉硬化发生发展的重要危险因素,临床上应高度重视。
Objective To investigate the relationship between levels of serum homocysteine(Hcy), glycated hemoglobin A1c(HbA1c) and carotid atherosclerosis in patients with acute cerebral infarction(ACI). Method Retrospective study had been used to accomplish continuous admission.A total of 236 ACI patients were adopted which mainly included large-artery atherosclerosis( LAA) and small-artery occlusion( SAO) according to the etiological typing of TOAST classification. According to the results of carotid artery ultrasound, all patients were divided into four groups: without plaque group, stable-plaque group, unstable-plaque group and stenosis group. We detected and analyzed the differences of serum Hcy and HbA1c between every each group. Univariate analysis was used to analyze whether there were significant differences in factors between different carotid atherosclerosis groups. Multivariate Logistic regression analysis was used to analyze the association of serum Hcy and HbA1c levels and carotid atherosclerosis. Results Age, triglyceride, low-density lipoprotein, Hcy, HbA1c, history of hypertension, smoking, alcohol consumption, and TOAST classification were significantly different between different degrees of carotid atherosclerosis( P<0.05). Multivariate Logistic regression analysis showed that elevatory serum Hcy and HbA1c were risk factors for carotid atherosclerosis in patients with ACI( OR values were 3.157, 0.451 respectively, 95% CI were 1.489-6.381, 0.167-1.281;P values were 0.019, 0.045). Conclusion The increase of serum glycated hemoglobin and Hcy is an important risk factor for the occurrence and development of carotid atherosclerosis in ACI with LAA and SAO.We should attach great importance to the monitoring in clinical practice.
作者
山媛
崔小丽
马妮
蒋锋
Shan Yuan;Cui Xiaoli;Ma Ni;Jiang Feng(Department of Neurology,the Shanxi Provincial People's Hospital,Xian 710068,China)
出处
《脑与神经疾病杂志》
2019年第6期371-374,共4页
Journal of Brain and Nervous Diseases
基金
陕西省重点研发计划项目(2017SF-268)
关键词
同型半胱氨酸
糖化血红蛋白
颈动脉硬化
急性脑梗死
Homocysteine
Glycated hemoglobin
Carotid atherosclerosis
Acute cerebral infarction
