摘要
目的分析颈动脉内中膜厚度(cIMT)、血同型半胱氨酸(Hcy)水平与脑白质变性(WML)严重程度的关联性。方法回顾性收集2019年1月至2021年3月南方医科大学第三附属医院神经内科收治的WML患者427例,均经头颅MRI确诊。通过医院病历系统收集患者的临床资料,根据Fazekas量表评分将其分为WML轻度组(1分,258例)和WML中重度组(≥2分,169例)。比较两组的临床资料,应用二分类logistic回归分析中重度WML的独立危险因素,应用ROC曲线分析cIMT、Hcy对WML严重程度的评估价值。结果与WML轻度组比较,WML中重度组年龄更大,男性占比更高,高血压、糖尿病、冠心病患病率更高,总胆固醇、甘油三酯、极低密度脂蛋白(VLDL)水平更低,而Hcy水平更高,cIMT更厚,差异有统计学意义(P<0.05)。二分类logistic回归分析结果显示,较大的年龄、合并高血压、合并糖尿病、更高水平的Hcy和右侧cIMT是中重度WML的独立危险因素(P<0.05)。ROC曲线分析结果显示,Hcy水平和右侧cIMT均具有评估WML严重程度的价值(P<0.05);且联合二者的评估效能更优,灵敏度为69.23%,特异度为77.52%。结论Hcy和右侧cIMT是中重度WML的独立危险因素,二者联合可有效评估WML的严重程度。
Objective To analyse the correlation of carotid intima-media thickness(cIMT)and blood homocysteine(Hcy)level with the severity of white matter lesions(WML).Methods Four hundred and twenty-seven WML patients admitted to Department of Neurology,the Third Affiliated Hospital of Southern Medical University from January 2019 to March 2021 were retrospectively collected,and all of them were diagnosed by cranial MRI.The clinical data of the patients were collected through the hospital medical record system,and the patients were divided into mild WML group(1 point,258 cases)and moderate-severe WML group(≥2 points,169 cases)according to the Fazekas scale score.The clinical data were compared between the two groups,and the independent risk factors of moderate-severe WML were analyzed by using binary logistic regression,and the value of cIMT and Hcy in evaluating the severity of WML was analyzed by using receiver operator characteristic(ROC)curve.Results Compared with the mild WML group,the moderate-severe WML group was older,with a higher proportion of male,higher prevalence rates of hypertension,diabetes and coronary heart disease,lower levels of total cholesterol,triglyceride and very low density lipoprotein(VLDL),higher level of Hcy and thicker cIMT,and the differences were statistically significant(P<0.05).The results of binary logistic regression analysis showed that older age,complicated hypertension,complicated diabetes,higher levels of Hcy and right-sided cIMT were the independent risk factors for moderate-severe WML(P<0.05).The results of ROC curve analysis showed that both Hcy level and right-sided cIMT had value in assessing the severity of WML(P<0.05);and the combination of the two indicators was more effective,with a sensitivity of 69.23%and a specificity of 77.52%.Conclusion Hcy and right-sided cIMT are the independent risk factors for moderate-severe WML,and the combination of the two indicators can effectively assess the severity of WML.
作者
孔令通
杨灿洪
陈家镒
吕田明
KONG Ling-tong;YANG Can-hong;CHEN Jia-yi(Department of Neurology, the Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China)
出处
《中国临床新医学》
2022年第3期223-227,共5页
CHINESE JOURNAL OF NEW CLINICAL MEDICINE
基金
广东省自然科学基金项目(编号:2021A1515010006,2020A1515110506)。
关键词
颈动脉内中膜厚度
同型半胱氨酸
脑白质变性
关联性
Carotid intima-media thickness(cIMT)
Homocysteine(Hcy)
White matter lesions(WML)
Correlation
