脑卒中高危人群同型半胱氨酸与颈动脉斑块的相关性及危险因素分析

发布时间：2018-04-30 01:02

本文选题：同型半胱氨酸 + 颈动脉斑块　；参考：《中国慢性病预防与控制》2016年01期

【摘要】：目的探讨影响脑卒中高危人群同型半胱氨酸(Hcy)与颈动脉斑块的危险因素以及两者的相关性,为社区开展脑卒中高危人群防治提供依据。方法于2014年10月采用单纯随机抽样方法抽取上海市嘉定区徐行镇小庙村55岁以上户籍人口1561人,依据《脑卒中高危人群筛查和干预试点项目管理办法(试行)》中规定,8项危险因素占3项以上或既往有卒中或短暂性脑缺血发作病史者确定为脑卒中高危人群,共595人。剔除未参加体检68人和可能影响数据结果的卒中或短暂性脑缺血发病史者107人,共获得420人完整体检数据。采用前进法,以是否有高同型半胱氨酸血症(HHcy)、颈动脉班块为因变量,单因素分析结果中与血浆Hcy、颈动脉斑块存在相关的危险因子为自变量,进行二分类赋值后作多因素logistic回归分析。结果单因素分析显示,研究人群中男性、年龄高、吸烟史和缺乏运动是血浆Hcy浓度升高的危险因素(P0.01,P0.05),而年龄高、高血压、糖尿病、缺乏运动、低密度脂蛋白胆固醇(LDL-C)异常和高Hcy是颈动脉斑块形成的危险因素(P0.01,P0.05);多因素logistic回归分析显示,年龄(OR=1.126,95%CI:1.087~1.167)、性别(OR=0.165,95%CI:0.103~0.264)、糖尿病(OR=0.580,95%CI:0.345~0.976)与HHcy相关。男性血浆Hcy浓度[(19.00±10.15)μmol/L]高于女性[(15.22±5.64)μmol/L],且随年龄增长Hcy浓度升高。年龄、患糖尿病和LDL-C异常与颈动脉斑块形成相关,Hcy及其他危险因素被排除。结论社区开展脑卒中高危人群防治,应重视和控制好血浆Hcy与血脂水平,以减缓颈动脉斑块的形成。
[Abstract]:Objective to investigate the risk factors and correlation between homocysteine cysteine (Hcyn) and carotid plaque in high risk population of stroke, and to provide evidence for prevention and treatment of high risk population of stroke in community. Methods in October 2014, a total of 1561 residents aged 55 and over were selected from Xiao Miao Village, Xuhang Zhen, Jiading District, Shanghai, using a simple random sampling method. According to the Management method of the pilot Project on screening and intervention of Stroke High risk population (trial), 595 people (595) were identified as the high risk group of stroke, according to the regulation that 8 risk factors accounted for more than 3 items or had a history of stroke or transient ischemic attack in the past. A total of 420 complete physical examination data were obtained by excluding 68 persons who did not participate in the physical examination and 107 patients who had a history of stroke or transient cerebral ischemia that might affect the results of the physical examination. The forward method was used to determine whether there was hyperhomocysteinemia and carotid artery block as dependent variables. The results of univariate analysis showed that the risk factors associated with plasma Hcyand carotid plaque were independent variables. The multivariate logistic regression analysis was performed after the two classification values were assigned. Results the univariate analysis showed that male, age, smoking history and lack of exercise were the risk factors for the increase of plasma Hcy concentration, while the elderly, hypertension, diabetes, and lack of exercise. Low density lipoprotein cholesterol (LDL-C) abnormality and high Hcy were the risk factors of carotid plaque formation (P 0.01) and multivariate logistic regression analysis showed that age OR 1.126% 95% CI: 1.0871.167%, sex ORO 0.165% 95% CIW 0.103 0.264, diabetes ORO 0.58095CIW 0.345C 0.976) were associated with HHcy. The plasma Hcy concentration in males [19.00 卤10.15 渭 mol/L] was higher than that in females [15.22 卤5.64 渭 mol/L], and the concentration of Hcy increased with age. Age, diabetes and LDL-C abnormalities were excluded from carotid plaque formation associated with homocysteine and other risk factors. Conclusion in order to slow down the formation of carotid plaque, the community should pay attention to and control plasma Hcy and blood lipids in order to prevent and treat the high risk population of cerebral apoplexy.
【作者单位】：嘉定区徐行镇社区卫生服务中心预防科;嘉定区疾病预防控制中心慢病科;第二军医大学卫生事业管理学教研室;
【分类号】：R743.3

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