急性缺血性卒中人群血清同型半胱氨酸水平临床特点

目的 回顾性分析急性缺血性脑卒中人群中血清同型半胱氨酸(HCY)水平的临床特点,探讨HCY升高相关的危险因素,为急性缺血性脑卒中的二级预防提供参考。方法 回顾性收集我院2019年1月-2019年12月经头颅MRI中DWI和ADC序列确诊为急性缺血性脑卒中的患者1 055例,收集一般临床资料及HCY水平,以性别和年龄进行分层分析。采用t检验或单因素方差方法比较组间指标有无统计学差异,采用二元逻辑回归方法分析HCY的相关危险因素。结果 1 055例急性缺血性脑卒中患者年龄28~98岁,平均(66.4±11.7)岁。HCY水平为3.7~115.5 μmol/L,平均(20.1±13.0) μmol/L。按性别分层的分析结果显示,女性年龄显著大于男性,而其HCY水平显著低于男性(均P<0.05)。按性别和年龄分层后的分析结果显示,在男性中不同年龄组间HCY水平无显著差异(P>0.05),在女性中不同年龄组间HCY水平不等,年龄>80岁人群HCY水平显著高于年龄<50岁及7180岁人群(均P<0.05)。二元逻辑回归分析结果显示,男性、年龄及2型糖尿病是HCY水平的独立危险因素。结论 急性缺血性脑卒中人群中男性、高龄和2型糖尿病患者HCY水平较高,在这类人群的二级预防中降低HCY水平可能使患者获益更大。

Clinical analysis of serum homocysteine in patients with acute ischemic stroke

Objective To retrospectively analyze the clinical characteristics of serum homocysteine(HCY) in patients with acute ischemic stroke(AIS) for the risk factors associated with increased HCY in AIS secondary prevention. Methods A restrespective study was performed in 1 055 patients diagnozed AIS by diffusion weighted imaging(DWI) and apparent diffusion coefficient(ADC) sequence of cranial MRI in our hospital from January 2019 to December 2019. General informations and HCY levels were based on gender and age. The T test or one-way analysis of variance(ANOVA) method was used to compare the difference between groups and binary Logistic regression method was used to analyze the risk factors for HCY. Results The age range for 1 055 AIS patients was 28 to 98 years, (66.4±11.7) years, HCY 3.7-115.5 μmol/L, (20.1±13.0) μmol/L. The stratified analysis based on gender showed that the age of female was significantly increased when comparing with males, while HCY of female was significantly decreased (all P<0.05). The stratified analysis based on the combination of gender and age showed the difference was not statistically significant in HCY level in males in different age groups (P>0.05). HCY level in females were different and HCY of patients aged over 80 years was significantly increased than aged under 50 years and aged 71-80 years (all P<0.05). Binary logistic regression analysis showed that the independent risk factors for HCY were male, age, and type 2 diabetes mellitus. Conclusion Higher HCY are noted in male, elderly, T2DM of AIS patients, the reduction of HCY may allow the patients to obtain greater benefits in the secondary prevention.