摘要
目的:探讨老年人脑小血管病(cerebral small vessel disease,CSVD)与血清同型半胱氨酸(homocysteine,Hcy)的相关性。方法:选取南通大学附属江阴医院住院的老年CSVD患者,通过多模式MRI检测各种CSVD表型,包括腔隙性脑梗死(lacunar infarctions,LIs)、脑白质高信号(white matter hyperintensities,WMHs)、脑微出血(cerebral microbleeds,CMBs)以及血管周围间隙扩大(enlarged perivascular space,EPVS),计算CSVD总负荷评分。根据CSVD总负荷评分分组,应用有序多分类Logistic回归模型确定CSVD总负荷的独立影响因素。应用Spearman等级相关法对Hcy与CSVD总负荷评分进行相关性分析。结果:共纳入182例老年CSVD患者,轻度组45例(24.73%),中度组72例(39.56%),重度组65例(35.71%)。老年CSVD患者中,CSVD表型以LIs和WMHs最为常见,各组CSVD表型组合有所不同。单变量分析显示,轻、中、重度组3组间年龄、糖尿病史、吸烟史、基线SBP、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、糖化血红蛋白和Hcy差异均有统计学意义(均P<0.05)。Logistic回归分析显示,年龄、糖尿病、LDL-C和Hcy是CSVD总体负担的独立影响因素。Spearman等级相关分析显示,Hcy与CSVD总负荷评分呈正相关(P=0.028)。结论:老年CSVD患者MRI中,其表型以LIs和WMHs最常见。年龄、糖尿病、LDL-C和Hcy是CSVD总体负担的独立影响因素;患者Hcy水平与CSVD总负荷评分呈正相关。
Objective:To investigate the correlation between cerebral small vessel disease(CSVD)and serum homocysteine(Hcy)in elderly patients.Methods:The elderly patients with CSVD admitted to Jiangyin Hospital Affiliated to Nantong University were selected.The phenotypes of CSVD,including lacunar infarctions(LIs),white matter hyperintensities(WMHs),cerebral microbleeds(CMBs)and enlarged perivascular space(EPVS),were detected by multimodal MRI.The total load score of CSVD was calculated.According to the score grouping of the total load of CSVD,the independent influencing factors of the total load of CSVD are determined by using the ordered multi classification Logistic regression model.Spearman rank correlation method was used to analyze the correlation between Hcy and the total load score of CSVD.Results:A total of 182 elderly patients with CSVD were included.45 cases(24.73%)in the mild group,72 cases(39.56%)in the moderate group,and 65 cases(35.71%)in the severe group were grouped.In elderly patients with CSVD,LIs and WMHs are the most common phenotypes of CSVD,and the combination of CSVD phenotypes is different among different groups.Univariate analysis showed that there were significant differences in age,diabetes history,smoking history,baseline SBP,low-density lipoprotein cholesterol(LDL-C),glycosylated hemoglobin and Hcy among the three groups(all P<0.05).Logistic regression analysis showed that age,diabetes,LDL-C and Hcy were independent factors affecting the total load score of CSVD.Spearman rank correlation analysis showed that Hcy was positively correlated with the total load score of CSVD(P=0.028).Conclusion:In MRI of elderly CSVD patients,LIs and WMHs are the most common phenotypes.Age,diabetes,LDL-C and Hcy were independent factors influencing the total load of CSVD.The Hcy level of patients is positively correlated with the total load score of CSVD.
作者
陶佳丽
陆强彬
柏燕燕
TAO Jiali;LU Qiangbin;BAI Yanyan(Emergency Department of Huaian First Hospital Affiliated to Nanjing Medical University,Jiangsu 223300;Neurology Department of Jiangyin Hospital Affiliated to Nantong University)
出处
《南通大学学报(医学版)》
2025年第3期268-271,共4页
Journal of Nantong University(Medical sciences)
基金
江阴市科技局项目(JY0603A021014210021PB)。
