H型高血压和脂蛋白相关磷脂酶A2对脑白质疏松症严重程度及预后的影响

目的 探讨H型高血压和脂蛋白相关磷脂酶A2(Lp-PLA2)对脑白质疏松症(LA)严重程度及预后的影响.方法 前瞻性入选沧州市中心医院2016年3月至2018年3月行头颅CT检查诊断有LA的住院患者,入院后24h内空腹化验血清Lp-PLA2;根据有无高血压和高同型半胱氨酸血症(Hhcy),把LA患者分为:A.同时伴高血...

Effects of H-type hypertension and Lipoprotein-associated phospholipase A2 levelsonseverity and prognosis of leukoaraiosis

Objective To determine the effects of H-ty pehypertension and lipoprotein-associated phospholipase A2 levels onseverity and prognosis of leukoaraiosis(LA).Methods Patients with LA diagnosed by CT in Cangzhou Central Hospital from Mar.2016 to Mar.2018 were collected.According to the presence or absence of hypertension and hyperhomocysteinemia(Hhcy),patients were divided into the following four groups:A H-hypertension group with hypertension and Hhcy;B simple hypertension group with only hypertension;C simple Hhcy group with only increased Hcy;D control group with normal blood pressure and Hcy.At 2 years follow up,primary endpoints were new stroke(ischemic and hemorrhagic stroke)and all-cause death.Results Of total 2204 patients,there were statistical differences amongthe4 groupsin severeleukoaraiosis(P<0.001),and H-typehypertension group had the highest rate of severe LA.Age,diabetes,smoking,Lp-PLA2,total cholesterol and H-hypertensionwere independent risk factors of severe LA.At 2 years follow up,more new stroke events occurred in H-type hypertension group(P<0.001),there were no statistical differences amongthe4 groupsin all-cause death(P=0.918).Age,Lp-PLA2,diabetes and H-type hypertension were independent risk factors of new stroke,while age,Lp-PLA2,smoking,diabetes and H-type hypertension were independent risk factors of all-cause death.Conclusion H-type hypertension and Lp-PLA2 were not only the independent risk factors of severeleukoaraiosis but also independent risk factors of new stroke and allcause death at 2 years follow up in LA patients.