脑卒中高危人群高同型半胱氨酸血症影响因素及中医证候研究

目的:研究脑卒中高危人群高同型半胱氨酸血症(Hyperhomocysteinemia,HHcy)的患病情况,并分析其危险因素,及与其颈动脉超声结果的相关性。方法:采用横断面流行病学调查的方法,将纳入的5 999例脑卒中高危人群分为HHcy组与无HHcy组,比较2组患者人口学资料、危险因素、生化化验结果、颈动脉超声检查结果的差异。结果:HHcy组患者脑卒中、高血压的患病率高于无HHcy组,TIA、血脂异常、糖尿病的患病率低于无HHcy组(P0.01)。多因素Logistic回归显示年龄、BMI、HDL、吸烟、饮酒是HHcy的危险因素。HHcy组颈动脉斑块形成的比例高于无HHcy组,多发斑块的比例高于无HHcy组,单发斑块或无斑块的比例低于无HHcy组。HHcy组的内火、痰湿证候要素所占的比例较高,无HHcy组的患者内风、气虚、阴虚所占的比例较高。结论:HHcy与脑卒中、高血压病有关,与颈动脉斑块形成有关,年龄、BMI、吸烟、饮酒是HHcy的危险因素。

Observation on the Influencial Factors and TCM Syndrome of Hyperhomocysteinemia among High Risk Population of Stroke

To observe the prevalence of hyperhomocysteinemia(HHcy) among high risk population of stroke and analyze its risk factors and relevance with the results of carotid artery ultrasound. Methods:The method of cross sectional epidemiologic study was adopted to divide the 5999 patients recruited into two groups: patients with HHcy and patients without HHcy. To compare the differences between the two groups in the aspects of demographic data, risk factors, biochemical assay, and the results of carotid artery ultrasound. Results:The prevalence of stroke and hypertension is higher among patients with HHcy than people without. The prevalence of TIA, dyslipidemia, diabetes is higher among people without HHcy than people with(P<0.01). Multiple factor analysis shows that age, BMI, HDL, smoking and drinking are the risk factors of HHcy. The proportion of carotid atherosclerotic plaques and multiple carotid atherosclerotic plaques are higher in patients with HHcy than patients without.The proportion of single plaque or no plaque is lower in group without HHcy. The proportion of syndrome factors of endogenous fire and phlegm dampness is higher in the group of HHcy than the other group. The proportion of syndrome factors of endogenous wind is lower in the group of HHcy than the other. Conclusion:HHcy is correlated with stroke, hypertension and carotid atherosclerotic plaques. Besides, age, BMI, HDL, smoking and drinking histories are the risk factors of HHcy.