同型半胱氨酸与青年脑梗死患者颈动脉硬化的相关性

目的探讨同型半胱氨酸(Hcy)水平与青年脑梗死患者颈动脉硬化的相关性,为降低青年脑梗死的发病率提供新的思路。方法对2007年1月至2013年12月入住东南大学附属中大医院神经内科的18~45周岁脑梗死患者的临床资料进行回顾性分析。通过颈动脉彩色多普勒超声检查,将入组的患者分为颈动脉硬化组、无颈动脉硬化组。比较两组患者的基本特征以及Hcy水平。计量资料用均数±标准差(x珋±s)表示,若数据服从正态性分布,组间差异显著性直接采用独立两样本t检验,若数据不服从正态性分布,则将数据先经过对数转化再进行独立两样本t检验。计数资料用频率表示,采用χ2检验。利用二分类Logistic回归分析校正非研究因素后,分析Hcy水平对颈动脉硬化的影响。P0.05为差异有统计学意义。结果研究共入选了104例研究对象,其中无动脉硬化组58例,动脉硬化组46例。两组在年龄、性别、吸烟、饮酒、高密度脂蛋白水平、甘油三酯水平、总胆固醇水平等方面差异无统计学意义(P0.05),在高血压病史(χ2=5.273,P=0.022)、糖尿病史(χ2=5.188,P=0.023)、低密度脂蛋白水平(t=2.505,P=0.014)及Hcy水平(t=3.580,P=0.001)方面差异具有统计学意义,颈动脉硬化组的Hcy水平高于无颈动脉硬化组。二分类Logistic回归分析显示,血Hcy浓度的升高,增加颈动脉硬化的形成(β=0.095,P=0.004)。结论我们的研究结果提示在青年脑梗死患者中高Hcy水平可以促进颈动脉硬化形成,这种影响独立于传统的危险因素。

Correlation between homocysteine and carotid atherosclerosis in young patients with cerebral infarction

Objective To explore the association between homocysteine （Hcy） concentration and carotid atherosclerosis in young cerebral infarction patients, providing new ideas for reducing the incidence of young cerebral infarction. Methods A retrospective analysis of data from patients aged 18 to 45 years consecutively treated for cerebral infarction in a neurology unit between January 2007 and December 2013 was performed. We graded carotid atherosclerosis using carotid duplex as： no atherosclerosis group and atherosclerosis group. Baseline characteristics and plasma levels of Hcy of these two groups were analyzed. The measurement data were presented as x ＋ s, if the data were distributed in a normal fashion, two independent samples t test was used to compare the differences between groups, and if the data were in an abnormal distribution, a logarithmic transformation would be done before two independent samples t test. Count data were presented as Frequency,and usingx~ test. Then binary logistic regression was used to adjust non study variables, and the effect of Hcy on carotid artery atherosclerosis was analyzed. A level of P 〈 0. 05 was considered as statistical significance. Results One hundred and four patients were included：58 in no atherosclerosis group and 46 in atherosclerosis group. The difference of age, sex, smoking, drinking, highdensity lipoprotein cholesterol,triglycerides and total cholesterol was not significant between these two groups （ P 〉 0.05 ）, whereas hypertension（χ2= 5. 273, P = 0. 022 ）, diabetes （χ2 = 5. 188, P = 0. 023 ）, low-density lipoprotein cholesterol（t = 2. 505, P = 0. 014 ） and Hcy （ t = 3. 580, P = 0. 001 ） were significant different. Atherosclerosis group＇s Hcy concentration was significantly higher than those in no atherosclerosis group. Binary logistic regression showed that, higher Hcy concentration in the blood can increase the formation of carotid atherosclerosis （β = 0. 095, P=0. 004 ）. Conclusion Our results show that high Hcy level can