摘要
目的探讨高同型半胱氨酸型高血压(H型高血压)与急性脑梗死的相关性。方法连续纳入经头部MRI确诊的急性脑梗死患者220例。将同期入院的120例短暂性脑缺血发作(TIA)患者作为对照组。记录患者的年龄、高血压、糖尿病、高脂血症和家族史等危险因素。于发病第2、3天空腹抽取所有受试者的静脉血,采用高效液相色谱法测定血清同型半胱氨酸(Hcy)水平。以Hcy≥10μmol/L作为高同型半胱氨酸血症(HHcy)的标准,高血压伴HHcy者为H型高血压。仅Hcy升高者为单纯HHcy组,仅血压升高者为单纯高血压组。结果①脑梗死组患者Hcy水平高于TIA组([19.7±8.3)μmol/L比(13.3±3.5)μmol/L;]高血压、HHcy、H型高血压的发生率高于TIA组,差异均有统计学意义,均P<0.01。②340例患者中,高血压患者的脑梗死发生率高于血压正常者(70.0%比51.6%;χ2=10.290,P<0.01);HHcy患者的脑梗死发生率高于Hcy正常者(70.2%比31.3%;χ2=27.396,P<0.01)。H型高血压组的脑梗死发生率(73.3%)高于单纯高血压组(42.3%)、单纯HHcy(61.3%)及血压和Hcy均正常组(18.2%),差异均有统计学意义(P<0.01,P<0.05)。③多因素Logistic回归显示,急性脑梗死的独立危险因素为H型高血压(OR=3.34,95%CI:1.59～7.02)和HHcy(OR=1.969,5%CI:1.15～3.36)。结论急性脑梗死患者Hcy水平高于TIA组的患者。H型高血压脑梗死的发生率较高,H型高血压可能是导致卒中事件的独立危险因素。
Objective To investigate the correlation between H-type hypertension and acute cerebral infarction. Methods A total of 220 consecutive patients with acute cerebral infarction diagnosed by head MRI were included in the study. At the same period, 120 hospitalized patients with transient ischemic attack （TIA） whose cerebral infarction were excluded with head MRI were used as the control group. The age, hypertension, diabetes, hyperlipidemia, family history and other risk factors of the patients were documented. The fasting venous samples of all the subjects were collected at day 2 and 3 after the onset. The level of serum homocysteine （Hey） was detected by using high-performance liquid chromatography. Using Hcy ≥10μmol/L as the standard of high homocysteine （Hhcy）, hypertensive patients with Hhcy were the H-type hypertension. The patients with the increased Hey only were the simple Hhcy group, and the patients with elevated blood pressure only were the sample hypertension group. Results ① The Hcy levels of the patients in the cerebral infarction group was higher than those in the control group. The incidences of hypertension, Hhcy and H-type hypertension were higher than those in the control group. The differences were statistically significant （ P 〈 0.01 ）. ②Among the 340 patients, the incidence of cerebral infarction in the hypertensive patients was higher than that in the normotensive subjects （X^2 = 10. 290, P 〈 0.01 ） ; the incidence of cerebral infarction in patients with Hhcy was higher than that in patients with normal Hcy （X2 =27. 396, P 〈 0.01 ）. The incidence of cerebral infarction in patients with H-type hypertension （73. 3% ） was higher than that in the simple hypertension group （42.3%）, the simple HHcy group （61.3%）, and both blood pressure and Hcy were normal group （ 18.2% ）. The differences were statistically significant （P 〈 0.05 or P 〈 0.01 ）. @Multivariate logistic regression analysis showed that the independent risk factors for acute cerebral infarction were H-type hypertension （ OR, 3.34, 95% CI： 1.59 -7.02） and Hhcy （ OR, 1.96, 95% CI： 1.15 -3.36）. Conclusion The Hcy levels of the patients with acute cerebral infarction is elevated, and the patients with H-type hypertension has higher incidence of cerebral infarction, H-type hypertension may be an independent risk factor for stroke events.
出处
《中国脑血管病杂志》
CAS
2011年第12期637-640,共4页
Chinese Journal of Cerebrovascular Diseases
基金
首都医科大学基础临床课题(11JL34)
