摘要
背景既往关于同型半胱氨酸(Hcy)、血尿酸(SUA)水平与大动脉脑梗死关系的研究报道较多,但二者与小穿通动脉闭塞所致腔隙性脑梗死的关系研究报道较少。目的探讨Hcy、SUA水平与腔隙性脑梗死的关系。方法选取2016年6月—2018年6月于河北工程大学附属医院神经内科住院的腔隙性脑梗死患者312例作为试验组,选取同期住院且颅脑磁共振成像(MRI)检查结果正常的患者88例作为对照组。比较两组患者一般资料(包括年龄、性别、吸烟史、饮酒史、高血压病史、糖尿病病史、冠心病病史)、实验室检查指标{包括总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、脂蛋白a〔Lp(a)〕、载脂蛋白A(Apo-A)、载脂蛋白B(Apo-B)、纤维蛋白原(FIB)、Hcy、SUA},Hcy、SUA水平与腔隙性脑梗死的关系分析采用多因素Logistic回归分析;绘制ROC曲线以评价Hcy、SUA对腔隙性脑梗死的诊断价值。结果(1)试验组患者年龄大于对照组,有高血压病史、糖尿病病史、冠心病病史者所占比例及TC、LDL-C、Lp(a)、Hcy、SUA水平高于对照组,HDL-C水平低于对照组(P<0.05);两组患者性别,有吸烟史、饮酒史者所占比例及TG、Apo-A、Apo-B、FIB水平比较,差异无统计学意义(P>0.05)。(2)多因素Logistic回归分析结果显示,Hcy〔OR=0.941,95%CI(0.889,0.996)〕、SUA〔OR=0.992,95%CI(0.988,0.996)〕是腔隙性脑梗死的独立影响因素(P<0.05)。(3)ROC曲线显示,Hcy诊断腔隙性脑梗死的曲线下面积为0.705〔95%CI(0.642,0.769)〕,最佳截断值为8.93μmol/L,灵敏度为93.3%,特异度为39.8%,Youden指数为0.330;SUA诊断腔隙性脑梗死的曲线下面积为0.718〔95%CI(0.659,0.777)〕,最佳截断值为251μmol/L,灵敏度为74.7%,特异度为60.2%,Youden指数为0.349。结论Hcy、SUA水平是腔隙性脑梗死的独立影响因素,且二者对腔隙性脑梗死均有一定诊断价值。
Background Previous studies on relations of homocysteine and serun uric acid(SUA)to aortic cerebral infarction are relatively numerous,however,few research has been done on relations of homocysteine and SUA to lacunar infarction caused by occlusion of small perforating cerebral arteries.Objective To investigate the relations of homocysteine and SUA to lacunar infarction.Methods From June 2016 to June 2018,312 inpatients with lacunar infarction were selected as test group in the Department of Neurology,the Affiliated Hospital of Hebei University of Engineering,meanwhile 88 inpatients with normal craniocerebral MRI results were selected as control group.General information(including age,gender,smoking history,drinking history,hypertension history,diabetes history and coronary heart disease history),laboratory examination results〔including TC,HDL-C,LDL-C,TG,Lp(a),Apo-A,Apo-B,FIB,homocysteine and SUA〕were compared between the two groups,and multivariate Logistic regression analysis was used to analyze the relations of homocysteine and SUA with lacunar infarction;ROC curve was drawn to evaluate the diagnostic value of homocysteine and SUA on lacunar infarction.Results(1)Age in test group was statistically significantly older than that in control group,proportions of patients with history of hypertension,diabetes and coronary heart disease,TC,LDL-C,Lp(a),homocysteine and SUA in test group were statistically significantly higher than those in control group,while HDL-C in test group was statistically significantly lower than that in control group(P<0.05);no statistically significant difference of gender,proportion of patients with history of smoking or drinking,TG,Apo-A,Apo-B or FIB was found between the two groups(P>0.05).(2)Multivariate Logistic regression analysis results showed that,homocysteine〔OR=0.941,95%CI(0.889,0.996)〕and SUA〔OR=0.992,95%CI(0.988,0.996)〕were independent influencing factors of lacunar infarction(P<0.05).(3)ROC curve showed that,AUC of homocysteine in diagnosing lacunar infarction was
作者
暴茜茜
郑连红
杨群玲
BAO Xixi;ZHENG Lianhong;YANG Qunling(Department of Neurology,the Affiliated Hospital of Hebei University of Engineering,Handan 056500,China)
出处
《实用心脑肺血管病杂志》
2019年第8期51-55,共5页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
