老年性脑白质疏松症与叶酸、维生素B12和同型半胱氨酸相关性研究

发布时间：2018-06-24 09:23

本文选题：脑白质疏松 + 叶酸　；参考：《大连医科大学》2014年硕士论文

【摘要】：目的：探讨叶酸、维生素B12减低和同型半胱氨酸(Homocysteine，HCY)升高对脑白质疏松症(Leukoaraiosis,LA)影响和不同严重程度脑白质疏松患者叶酸、维生素B12和同型半胱氨酸水平变化趋势。研究脑白质疏松形成的相关因素。方法：选取2013年4月-2014年1月期间以头晕头昏为主诉且无神经系统阳性体征于大连医科大学附属第一医院神经内科住院部就诊患者72例，年龄集中在65岁至89岁之间。所选取72例患者均行头磁共振成像(Magnetic resonanceimaging,MRI)检查。其中发现仅有脑白质疏松的患者36例，将其作为病例组；无脑白质疏松的患者36例，，将其作为对照组。根据脑白质疏松国际分级标准Kinkel分级法，将脑白质疏松组(LA组)患者分为脑白质疏松1级(LA1)、脑白质疏松2级(LA2)、脑白质疏松3级(LA3)和脑白质疏松4级(LA4)四个组。同时检测所有患者血清叶酸、维生素B12和同型半胱氨酸浓度。并且收集所选取患者临床资料，包括性别、年龄、有无高血压病史、有无糖尿病病史、有无冠心病病史、有无吸烟史、有无饮酒史、有无腔隙性脑梗死。运用t检验或秩和检验比较LA组和对照组组、LA2组和LA1组之间血清叶酸、维生素B12和同型半胱氨酸水平。运用卡方检验和二项logistic回归分析，研究影响脑白质疏松形成的相关因素。结果：在对LA组和对照组之间运用卡方检验对性别、年龄进行检验，各组间结果均无统计学差异(P0.05)。而在LA组和对照组、LA2组和LA1组间运用t检验对血清叶酸、维生素B12和同型半胱氨酸水平进行检验，差异均有统计学意义(P0.05)。运用卡方检验显示，高血压、腔隙性脑梗死和吸烟在LA组和对照组之间的差异有统计学意义(P0.05)，其它因素如糖尿病、冠心病和饮酒在两组之间差异无统计学意义(P0.05)。对高血压、腔隙性脑梗死和吸烟三个因素进行二项logistic回归分析比较，发现高血压、腔隙性脑梗死和吸烟为脑白质疏松的危险因素。结论：1.脑白质疏松的发生与血清叶酸、维生素B12水平减低，血清同型半胱氨酸水平升高密切相关。且随着叶酸、维生素B12水平越低及血清同型半胱氨酸水平越高，与脑白质疏松严重程度越重相关。 2.高血压、腔隙性脑梗死和吸烟与脑白质疏松发生相关，且为脑白质疏松发生发展的危险因素。糖尿病、冠心病和饮酒与脑白质疏松发生无相关性。
[Abstract]:Objective: to investigate the effects of folic acid, vitamin B12 reduction and homocysteine (HCY) on leukoaraiosis (LeukoaraiosisLA) and the changes of folic acid, vitamin B12 and homocysteine levels in patients with different severity of leukoaraiosis. To study the factors related to the formation of leukoaraiosis. Methods: from April 2013 to January 2014, 72 patients with dizziness and dizziness were selected from the Department of Neurology, Department of Neurology, first affiliated Hospital of Dalian Medical University, aged 65 to 89 years. Magnetic resonance imaging (MRI) was performed in 72 patients. 36 cases of leukoaraiosis were found as case group and 36 cases of anencephaly as control group. According to Kinkel classification method, the patients in the leukoaraiosis group (LA group) were divided into four groups: leukoaraiosis grade 1 (LA1), leukoaraiosis grade 2 (LA2), leukoaraiosis grade 3 (LA3) and leukoaraiosis grade 4 (LA4). Serum folic acid, vitamin B 12 and homocysteine concentrations were also measured in all patients. The clinical data including sex, age, hypertension history, diabetes history, coronary heart disease history, smoking history, drinking history and lacunar cerebral infarction were collected. Serum folic acid, vitamin B12 and homocysteine levels were compared between LA group and control group by t test or rank sum test. By using chi-square test and binomial logistic regression analysis, the factors related to the formation of leukoaraiosis were studied. Results: chi-square test was used to test gender and age between LA group and control group. There was no statistical difference between the two groups (P0.05). The serum levels of folic acid, vitamin B12 and homocysteine were detected by t test in LA group and control group (P0.05). Chi-square test showed that there was significant difference between LA group and control group in hypertension, lacunar cerebral infarction and smoking (P0.05), while other factors such as diabetes, coronary heart disease and alcohol consumption had no significant difference between the two groups (P0.05). Three factors, hypertension, lacunar cerebral infarction and smoking, were analyzed by binary logistic regression analysis. It was found that hypertension, lacunar infarction and smoking were risk factors of leukoaraiosis. Conclusion 1. The occurrence of leukoaraiosis was closely related to the decrease of serum folic acid and vitamin B12 levels and the increase of serum homocysteine level. With folic acid, the lower the level of vitamin B12 and the higher the level of serum homocysteine, the more serious the severity of leukoaraiosis. Hypertension, lacunar infarction and smoking were associated with leukoaraiosis and were risk factors for the development of leukoaraiosis. Diabetes, coronary heart disease and alcohol consumption were not associated with leukoaraiosis.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R742

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