高同型半胱氨酸与非瓣膜心房颤动合并脑卒中的相关性
发布时间：2018-12-26 08:17
【摘要】：目的：观察房颤、单纯脑卒中、房颤合并脑卒中患者血清中的同型半胱氨酸（HCY）的水平及评估高同型半胱氨酸（Hhcy）是否为非瓣膜房颤合并脑卒中的独立预测因子。 方法：选取非瓣膜房颤患者50例，单纯脑卒中患者50例，非瓣膜房颤合并脑卒中患者48例，，正常对照人群50例。分别采空腹静脉血液3ml,同型半胱氨酸采用美国AU5400循环酶法测定，D-D聚体采用透射免疫比浊法测定。比较四组同型半胱氨酸水平有无显著性差异。 结果：1、与正常组比较，房颤组HCY水平升高(16.26±0.72μmol/L vs9.94±4.24μmol/L，P0.05)；单纯脑卒中组HCY水平升高(21.86±0.93μmol/L vs9.94±4.24μmol/L，P0.05)；房颤合并脑卒中组HCY水平升高(23.41±3.37μmol/Lvs9.94±4.24μmol/L，P0.05)。房颤合并脑卒中组HCY水平明显高于房颤组(23.41±3.37μmol/Lvs16.26±0.72μmol/L，P0.05)；房颤合并脑卒中组HCY水平较单纯脑卒中组升高，但无统计学差异（23.41±3.37μmol/Lvs21.86±0.93μmol/L，P0.05）。2、HCY17μmol/L为阳性标准，房颤合并脑卒中组与房颤组的阳性检出率比较有统计学差异（P0.05），HCY明显升高的房颤患者发生脑卒中的危险是HCY不升高房颤患者的4.12倍。3、房颤组与房颤合并脑卒中组比较：65岁以上的老年人在房颤合并脑卒中组占97.67%，高于房颤组52%，P0.05；房颤合并卒中组伴发高血压72.92%，而房颤组仅为46%，P0.05；房颤合并脑卒中组伴糖尿病者占25%，而房颤组仅占8%，P0.05；房颤合并脑卒中组伴高脂血症者占72.92%，房颤组占48%，P0.05。提示房颤合并脑卒中组在年龄≥65岁，伴发高血压、糖尿病、高脂血症方面的发生率均高于房颤组。4、Logistic回归结果显示：高同型半胱氨酸（OR=1.696，P0.05）、高龄(OR=1.607,P0.05)是非瓣膜房颤合并脑卒中的独立危险因素。5、Spearman相关性分析示：同型半胱氨酸与D-D聚体无相关性。 结论：1、血清同型半胱氨酸升高易致脑卒中。 2、血清同型半胱氨酸在非瓣膜心房颤动及非瓣膜房颤合并脑卒患者中升高。 3、同型半胱氨酸明显升高的房颤患者比同型半胱氨酸不升高的房颤患者更易发生脑卒中。 4、年龄≥65岁，高血压、糖尿病、高脂血症是房颤合并脑卒中的危险因素。
[Abstract]:Aim: to observe the level of homocysteine (HCY) in serum of patients with atrial fibrillation, simple stroke and atrial fibrillation with stroke and to evaluate whether high homocysteine (Hhcy) is an independent predictor of non-valvular atrial fibrillation with stroke. Methods: fifty patients with non-valvular atrial fibrillation, 50 patients with simple stroke, 48 patients with non-valvular atrial fibrillation complicated with stroke and 50 normal controls were selected. Fasting venous blood samples were collected. Homocysteine was determined by AU5400 circulatory enzyme method and D-D polymer by transmission immunoturbidimetry. To compare the difference of homocysteine level among the four groups. Results: 1, compared with the normal group, the level of HCY in AF group was increased (16.26 卤0.72 渭 mol/L vs9.94 卤4.24 渭 mol/L,P0.05), the HCY level in stroke group was increased (21.86 卤0.93 渭 mol/L vs9.94 卤4.24 渭 mol/L,P0.05). The level of HCY in patients with atrial fibrillation and stroke was increased (23.41 卤3.37 渭 mol/Lvs9.94 卤4.24 渭 mol/L,P0.05). The level of HCY in AF with stroke group was significantly higher than that in AF group (23.41 卤3.37 渭 mol/Lvs16.26 卤0.72 渭 mol/L,P0.05). The level of HCY in atrial fibrillation with stroke group was higher than that in simple stroke group, but there was no statistical difference (23.41 卤3.37 渭 mol/Lvs21.86 卤0.93 渭 mol/L,P0.05) .2HCY17 渭 mol/L was the positive standard. There was significant difference in the positive detection rate between the patients with atrial fibrillation complicated with stroke and those with atrial fibrillation (P0.05). The risk of cerebral apoplexy in patients with atrial fibrillation (), HCY) was 4.12 times higher than that in patients with atrial fibrillation (HCY) was 4.12 times higher than that in patients with atrial fibrillation. Comparison between atrial fibrillation group and atrial fibrillation with stroke group: the elderly over 65 years old accounted for 97.67% of atrial fibrillation with stroke group, which was higher than 52% of atrial fibrillation group (P 0.05). In the AF with stroke group, the incidence of hypertension was 72.92%, while that in the AF group was only 46% (P0.05), and that in the AF with stroke group was 25%, while that in the AF with stroke group was only 8% (P0.05). The incidence of hyperlipidemia was 72.92 in atrial fibrillation with stroke group and 48 in atrial fibrillation group (P 0.05). The results suggest that the incidence of hypertension, diabetes and hyperlipidemia in patients with atrial fibrillation and stroke is higher than that in patients with atrial fibrillation and stroke. 4 the results of logistic regression showed that the incidence of hyperhomocysteine (OR=1.696,P0.05) was higher than that in patients with atrial fibrillation. Age (OR=1.607,P0.05) is an independent risk factor for non-valvular atrial fibrillation associated with stroke. 5Spearman correlation analysis showed that homocysteine was not associated with D-D polymer. Conclusion: 1. The increase of serum homocysteine may lead to stroke. 2. Serum homocysteine was elevated in patients with non-valvular atrial fibrillation and non-valvular atrial fibrillation with stroke. 3. Patients with atrial fibrillation with significantly increased homocysteine were more likely to have stroke than those with atrial fibrillation with no increase in homocysteine. 4, age 鈮
本文编号：2391803
[Abstract]:Aim: to observe the level of homocysteine (HCY) in serum of patients with atrial fibrillation, simple stroke and atrial fibrillation with stroke and to evaluate whether high homocysteine (Hhcy) is an independent predictor of non-valvular atrial fibrillation with stroke. Methods: fifty patients with non-valvular atrial fibrillation, 50 patients with simple stroke, 48 patients with non-valvular atrial fibrillation complicated with stroke and 50 normal controls were selected. Fasting venous blood samples were collected. Homocysteine was determined by AU5400 circulatory enzyme method and D-D polymer by transmission immunoturbidimetry. To compare the difference of homocysteine level among the four groups. Results: 1, compared with the normal group, the level of HCY in AF group was increased (16.26 卤0.72 渭 mol/L vs9.94 卤4.24 渭 mol/L,P0.05), the HCY level in stroke group was increased (21.86 卤0.93 渭 mol/L vs9.94 卤4.24 渭 mol/L,P0.05). The level of HCY in patients with atrial fibrillation and stroke was increased (23.41 卤3.37 渭 mol/Lvs9.94 卤4.24 渭 mol/L,P0.05). The level of HCY in AF with stroke group was significantly higher than that in AF group (23.41 卤3.37 渭 mol/Lvs16.26 卤0.72 渭 mol/L,P0.05). The level of HCY in atrial fibrillation with stroke group was higher than that in simple stroke group, but there was no statistical difference (23.41 卤3.37 渭 mol/Lvs21.86 卤0.93 渭 mol/L,P0.05) .2HCY17 渭 mol/L was the positive standard. There was significant difference in the positive detection rate between the patients with atrial fibrillation complicated with stroke and those with atrial fibrillation (P0.05). The risk of cerebral apoplexy in patients with atrial fibrillation (), HCY) was 4.12 times higher than that in patients with atrial fibrillation (HCY) was 4.12 times higher than that in patients with atrial fibrillation. Comparison between atrial fibrillation group and atrial fibrillation with stroke group: the elderly over 65 years old accounted for 97.67% of atrial fibrillation with stroke group, which was higher than 52% of atrial fibrillation group (P 0.05). In the AF with stroke group, the incidence of hypertension was 72.92%, while that in the AF group was only 46% (P0.05), and that in the AF with stroke group was 25%, while that in the AF with stroke group was only 8% (P0.05). The incidence of hyperlipidemia was 72.92 in atrial fibrillation with stroke group and 48 in atrial fibrillation group (P 0.05). The results suggest that the incidence of hypertension, diabetes and hyperlipidemia in patients with atrial fibrillation and stroke is higher than that in patients with atrial fibrillation and stroke. 4 the results of logistic regression showed that the incidence of hyperhomocysteine (OR=1.696,P0.05) was higher than that in patients with atrial fibrillation. Age (OR=1.607,P0.05) is an independent risk factor for non-valvular atrial fibrillation associated with stroke. 5Spearman correlation analysis showed that homocysteine was not associated with D-D polymer. Conclusion: 1. The increase of serum homocysteine may lead to stroke. 2. Serum homocysteine was elevated in patients with non-valvular atrial fibrillation and non-valvular atrial fibrillation with stroke. 3. Patients with atrial fibrillation with significantly increased homocysteine were more likely to have stroke than those with atrial fibrillation with no increase in homocysteine. 4, age 鈮
本文编号：2391803
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