摘要
目的探讨脑梗死患者血清同型半胱氨酸（Hcy）水平、载脂蛋白B（ApoB）／载脂蛋白A1（ApoA1）比值与颅内外血管狭窄的相关性。方法对行数字减影血管造影术（DSA）检查的184例脑梗死患者进行分组，颅内外血管狭窄组（狭窄组）158例、颅内外血管正常组（对照组）26例；按狭窄部位又将狭窄组分为单纯颅内血管狭窄组48例（颅内组）、单纯颅外血管狭窄组60例（颅外组）及颅内外血管狭窄组50例（颅内外组）。检测血浆Hey与载脂蛋白A1、载脂蛋白B水平，并计算比值，比较其与颅内外血管狭窄的相关性。结果（1）狭窄组血清Hey、ApoB、ApoB／ApoA1值和高Hcy发生率分别为（16．9±8．1）μmol／L、（1．02±0．25）g／L、（0．94±0．50）g／L、40％，对照组分别为（8．6±4．6）μmol／L、（0．86±0．22）g／L、（0．644-0．21）g／L和0，两组差异均有统计学意义（P〈0．01）。（2）颅内组、颅外组、颅内外组血清Hcy、ApoB／ApoA1水平组间差异无统计学意义。（3）多元逐步Logistic回归分析发现，血清Hcy水平升高（OR=1．146，95％CI：1．021—1．287；P=0．021），ApoB／ApoA1比值升高（OR=4．71，95％CI为1．70—14．20，P=0．005），ApoB水平升高（OR=4．50，95％CI为1．62～12．80，P=0．007），HDL降低（OR=0．089，95CI：0．014～0．551，P=0．017），Cho水平升高（OR=2．406；95％CI：1．145～5．055：P=0．023）是颅内外血管狭窄的危险因素。结论血清同型半胱氨酸水平升高及载脂蛋白B与载脂蛋白A1比值水平升高是颅内外血管狭窄的危险因素。
Objective To investigate the correlation of the plasma homocysteine level and serum B/apoli- poprolionAl（ApoB/ApoA1） radio with cerebral vascular stenosis in patients with cerebral infarction. Methods 184 patients with cerebral infarction experienced cerebral digital substraction angiography （DSA） were selected. Among them, 158 patients with cerebrovascular stenosis and 26 patients without stenosis were included. Three groups were categorized by distribution of artery lesion sites ： isolated intracranial artery stenosis （ n = 48 ）, isolated extracranial artery stenosis（ n = 60 ） co-existing of intracranial and extracranial artery stenosis（ n = 50）. The correlation analysis was made between the levels of Hcy and ApoB/ApoA1 with cerebral vascular stenosis in patients with cerebral infarction. Results （ 1 ） The proportion of subjects with high level of plasma homoeysteine was significantly higher in patients with cerebrovascular stenosis than those without [ （ 16.9 ± 8.1 ） μmoL/L vs （ 8.6 ± 4.6 ） μmol/L, P 〈 0. 001 ;40% vs 0, P 〈 0.01 ]. The proportion of subjects with high level of ApoB and ApoB/ApoA1 ratio was significantly higher in patients with cerebrovascular stenosis than those without ApoB [ （ 1.02± 0.25 ） vs （ 0.86 ± 0. 22 ） g/L, P 〈 0.01 ] , ApoB/ApoA1 ratio [ （ 0.94± 0.50 ） vs （ 0.64 ±0. 21, P 〈 0.01 ） ]. （ 2 ） For the different groups of artery lesion sites, the proportion of subjects with high level of plasma homocysteine was not significantly different[ （16.1 ± 8.5 ）mmol/ L, （ 17.0 ± 8.9 ） mmoL/L, （ 16.7 ± 8.7 ） mmol/L, P 〉 0. 05 ], the proportion of subjects with ApoB/ApoA1 ratio was not significantly different [ 0.98 ± 0.45,0.93 ± 0.48,0.96 ± 0.50, P 〉 0. 05 ]. （ 3 ） Based on muhivariable stepwise Logistic regression model, the increased level of Hey （ OR = 1. 146,95 % CI ： 1. 021 - 1. 287 ; P = 0. 021 ） , the increased level of ApoB/ApoAl（ OR =4.71,95% CI：I. 70 - 14.20,P =0.005） ,the increased level of ApoB（ OR =4.50,95% CI 为 1.62 ±12.80,P = 0.007 ）, the increased level of Cho （ OR = 2. 406 ; 95% CI ： 1. 145 - 5. 055 ; P = 0.023 ）, the decresed level of HDL（OR =0.089,95%CI：0.014 -0.551 ,P =0.017）were all risk factors. Conclusion High level of plasma homocysteine and ApoB/ApoA1 were both independent risk factors for cerebral vascular stenosis.
出处
《中国基层医药》
CAS
2012年第19期2908-2910,共3页
Chinese Journal of Primary Medicine and Pharmacy
基金
安徽省科技计划项目（08020303069）
关键词
脑梗死
同型半胱氨酸
载脂蛋白
血管疾病
Cerebral infarction
Hyperhomocysteinemia
Apolipoprolion
Vascular Diseases
