同型半胱氨酸与脑小血管病的相关性研究

目的探讨血浆同型半胱氨酸(Hcy)水平与脑小血管病(SVD)的相关性。方法回顾性分析218例脑SVD患者的临床资料,并根据诊断将其分为无症状脑梗死组(SBI,56例),脑白质疏松组(LA,143例),颅外段动脉硬化组(EC,28例),颅内段动脉硬化组(IC,31例)。测定所有患者的血浆Hcy水平,分析其对脑SVD发病的影响。结果脑SVD患者以老年女性居多,高血压、糖尿病比例高,且尿酸、Hcy、CRP水平也普遍升高。单因素logistic分析显示,血浆Hcy均是SBI、LA、EC、IC发生的危险因素,而多因素logistic回归分析显示,血浆Hcy是SBI(OR:3.47,95%CI:1.76⁴.65)、LA(OR:2.98,95%CI:1.484.65)、LA(OR:2.98,95%CI:1.48⁵.64)的独立危险因素(P<0.05),而血浆Hcy与EC、IC无明显相关性(P>0.05)。LA患者中随着Fazekas分级的增加,血浆Hcy水平依次升高(P<0.05)。结论血浆Hcy与脑SVD,尤其是SBI、LA具有相关性,是脑SVD发病的独立危险因素,但与脑大血管病变(EC、IC)之间的关系不明显。

Study on the relationship between plasma homocysteine and cerebral small vessel disease

Objective To explore the relationship between plasma homocysteine （ Hcy） and cerebral small vessel disease （SVD）.Methods Clinical data on 218 patients with cerebral SVD was retrospectively analyzed , and all the cases were divided into SBI group （n=56）, cWMH group（n=143）, EC group（n=28）, IC group（n=31） according to the diagnosis .Plasma Hcy was determined to analyze its impact on cerebral SVD .Results Cerebral SVD had a higher prevalence of old age , female gender , hypertension , DM, and had higher values for uric acid , Hcy, CRP than those without SVD .Univariate logistic analysis showed that plasma Hcy was risk factors for SBI , LA, EC, IC （P0.05）.With the increase of Fazekas ’ grade, plasma Hcy levels increase in turn among LA patients （P〈0.05）.Conclusion Plasma Hcy is correlated with cerebral SVD , especially SBI, LA, is an independent risk factors of cerebral SVD , but not found to be obviously associated with cerebral large vessel disease such as EC, IC.