摘要
目的探讨缺血性脑卒中患者吸烟与高同型半胱氨酸血症（HHe）的关系，并分析二者在缺血性脑卒中不同分型中的差异。方法病例一对照研究，伴HHe的缺血性脑卒中患者329例，不伴HHe的306例，分别调查两组年龄、性别、症状、体征、吸烟史、血浆同型半胱氨酸（Hcy）及血清叶酸、维生素B12浓度。再按TOAST分型将全部635例分为大血管病变398例与小血管病变237例，与患者的吸烟及Hcy水平做进一步的分析。结果伴HHe组的每日吸烟量、吸烟年限及吸烟指数明显高于不伴HHe组（均P〈0．01），吸烟指数与血浆Hcy浓度显著正相关（P〈0．01），与叶酸及维生素B12浓度显著负相关（均P〈0．01）。男性患者血浆Hcy浓度明显高于女性（P〈0．01）。小血管病变组与大血管病变组每日吸烟量、吸烟年限、吸烟指数、以及血浆Hcy浓度差异有统计学意义（P〈0．01，P〈0．01，P〈0．05，P〈0．01）。结论吸烟可能是缺血性脑卒中患者血浆Hcy升高的危险因素，吸烟与HHe更趋向引起大血管病变。
Objective To study the relationship between smoking and hyperhomocysteinemia （HHe） in ischemic stroke patients. Methods The clinical data of 329 ischemic stroke patients with HHe and 306 age-matched isehemic stroke patients without HHe, including sex, symptoms, signs, history of smoking, and plasma homocysteine （Hey）, folate, and vitamin B12 concentrations were compared. The ischemie stroke lesions were divided into 2 subtypes： large vessel disease group and small vessel disease group according to the TOAST system. Result The number of cigarettes smoked per day, cumulative year of smoking, and smoking index （ number of cigarettes smoked per day X cumulative year of smoking）, and ratio of males of the HHe group were all significantly higher than those of the non-HHe group, and the plasma homocysteine, folate, and vitamin B^2 concentrations of the HHe group were all significantly lower than those of the non-HHe group （ all P 〈 0.01 ）. Smoking index was positively correlated with the Hey concentrations and negatively correlated with the folate and vitamin B12 concentrations （ all P 〈 0.01 ）. The smoking proportion and Hey concentration of the male patients were significantly higher than those of the female patients（ both P 〈0.01 ）, and the plasma folate and vitamin Bt2 concentrations of the male patients were all significantly lower than those of the female patients （ P 〈 0. 01 and P 〈 0. 05 ）. The number of cigarettes smoked per day, cumulative year of smoking, smoking index, and Hey concentration of the large vessel disease group were all significantly higher than those of the small vessel disease group （ all P 〈 0. 01 ）. Conclusion Smoking and being male may be the risk factors of HHe in ischemic stroke patients. Smoking and HHe are prone to cause lesion in large vessel.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2008年第47期3342-3344,共3页
National Medical Journal of China
基金
首都医学发展科研基金资助项目（SF07-17-02）
关键词
同型半胱氨酸
吸烟
脑缺血
危险因素
Hyperhomocysteine
Smoking
Ischemic stroke
Risk factor
