同型半胱氨酸与颈动脉粥样硬化严重程度的关系
发布时间：2018-11-05 16:45
【摘要】：同型半胱氨酸(homocysteinemia Hcy)是体内甲硫氨酸即蛋氨酸循环过程中所产生的中间物质,不能直接合成蛋白质,2010年中国高血压防治指南将血浆Hcy浓度10μmol/L定义为高同型半胱氨酸血症(hyperhomocysteinemia HHcy)。大量的流行病学调查以及临床实验均显示,轻度至中度的Hcy升高是血管缺血性疾病的重要因素之一,独立于传统的动脉硬化风险因素。目的:研究血浆同型半胱氨酸水平与颈动脉粥样硬化及狭窄程度的相关性。方法:入选2015年12月至2016年11月之间于吉林大学第二医院老年病科就诊,且行颈动脉彩色多普勒超声检查的495例患者作为研究对象。其中包括女性205例,男性290例,平均年龄为64.92±9.16岁。其中除外口服B族维生素、叶酸、避孕药等影响同型半胱氨酸代谢药物的患者,除外心源性及其他原因所致颈动脉血栓的患者,排除心肺肝肾功能衰竭、甲状腺功能障碍患者。所有入选患者均于入院后采集空腹肘静脉血,测定血常规、肝功能、血脂、肾功能、血糖及同型半胱氨酸等指标,详细询问既往有无糖尿病、高血压病病史及吸烟饮酒史,并采用颈动脉彩色多普勒超声仪检查患者颈动脉内中膜厚度(Inner medial thickness IMT)、有无斑块形成以及斑块性质,综合评估患者颈动脉粥样硬化及狭窄程度,根据检查结果将患者分为正常组、IMT增厚组、斑块形成组、中重度狭窄组,将颈动脉正常组定义为对照组,采用单因素方差分析比较四组之间血浆Hcy水平,研究血浆Hcy水平与颈动脉粥样硬化及狭窄程度之间的相关性,采用非参数检验分析比较其他因素与颈动脉粥样硬化的相关性,最后采用多元线性回归分析,排除其他因素影响后,确定哪几种因素是预测颈动脉粥样硬化的独立危险因素。所有数据均应用SPSS22.0软件包进行统计学处理,所有分析结果均以P0.05为差异有统计学意义。结果:1颈动脉粥样硬化组患者年龄及吸烟患者所占比例明显高于对照组,两组比较均有明显统计学差异(P0.05)。2动脉粥样硬化组患者的血浆Hcy水平明显高于对照组,两组差异有统计学意义(P0.05);颈动脉粥样硬化各组之间血浆Hcy水平比较发现,IMT增厚组斑块形成组中重度狭窄组,各组之间差异均有统计学意义(P0.05)。3颈动脉粥样硬化组患者的超敏C反应蛋白(Hypersensitive C reactive protein HSCRP)水平明显高于对照组,两组差异有统计学意义(P0.05);颈动脉粥样硬化组患者的尿酸(Uric acid UA)水平明显高于对照组,差异有统计学意义(P0.05)。4男性患者的血浆Hcy水平明显高于女性患者,且两者存在显著统计学差异(P0.05);吸烟患者的血浆Hcy水平高于非吸烟患者,两者差异有统计学意义(P0.05)。5在校正了性别、年龄、高血压、糖尿病、胆固醇(Cholesterol CHOL)、低密度脂蛋白(Low-density lipoprotein LDL)、同型半胱氨酸、尿酸、甘油三酯(Triglycerides TG)、超敏C反应蛋白等因素的影响后,性别、年龄、同型半胱氨酸以及超敏C反应蛋白均可以作为预测颈动脉粥样硬化及狭窄程度的独立危险因素。结论:1血浆同型半胱氨酸水平与颈动脉粥样硬化及狭窄程度呈明显正相关,血浆Hcy水平越高,患者颈动脉粥样硬化及狭窄程度越重。2在校正了性别、年龄、高血压、糖尿病、CHOL、TG、LDL、Hcy、UA、HSCRP等因素的影响后,血浆同型半胱氨可以作为预测颈动脉粥样硬化及狭窄程度的独立危险因素。
[Abstract]:The same type of cysteine (Hcy) is the intermediate substance produced during the circulation of methionine in the body, which cannot be directly synthesized. In 2010, the Chinese hypertension prevention and control guideline defined plasma Hcy concentration of 10. m u.mol/ L as hyperhomocysteinemia HHcy. A large number of epidemiological investigations and clinical trials show that mild to moderate Hcy elevation is one of the important factors in vascular ischemic diseases, independent of traditional risk factors for arteriosclerosis. Objective: To study the correlation between plasma homocysteine level and carotid atherosclerosis and stenosis degree. Methods: 495 patients were enrolled in the geriatrics department of the Second Hospital of Jilin University from December 2015 to November 2016, and 495 patients with carotid color Doppler ultrasound were used as research subjects. Among them, 205 males and 290 males were females, with an average age of 64. 92 and 9. 16 years. The patients with carotid thrombosis associated with the same type of cysteine metabolism, except cardiogenic and other causes, excluded from the group B vitamins, folic acid, and contraceptives, excluded cardiopulmonary and renal function failure and thyroid dysfunction. All enrolled patients were admitted to the hospital to collect fasting cubitus venous blood, determine blood routine, liver function, blood lipid, renal function, blood glucose and homocysteine and so on. The carotid artery color Doppler ultrasound was used to examine the thickness of carotid artery (IMT), plaque formation and plaque properties, and the carotid atherosclerosis and stenosis degree of patients were evaluated. The correlation between plasma Hcy level and carotid atherosclerosis and stenosis degree was studied by using single factor analysis of variance to compare plasma Hcy level between the four groups. The correlation between other factors and carotid atherosclerosis was analyzed by non-linear regression analysis. Finally, multivariate linear regression analysis was used to determine which factors were the independent risk factors for predicting carotid atherosclerosis. All the data were treated with SPSS22. 0 software package. All the results were statistically significant with P0.05. Results: The proportion of patients with carotid atherosclerosis was significantly higher than that in control group (P <0.05). The plasma Hcy level in atherosclerotic group was significantly higher than that in control group (P <0.05). 棰堝姩鑴夌播鏍风‖鍖栧悇缁勪箣闂磋娴咹cy姘村钩姣旇緝鍙戠幇,IMT澧炲帤缁勬枒鍧楀舰鎴愮粍涓噸搴︾嫮绐勭粍,鍚勭粍涔嬮棿宸紓鍧囨湁缁熻瀛︽剰涔，
本文编号：2312683
[Abstract]:The same type of cysteine (Hcy) is the intermediate substance produced during the circulation of methionine in the body, which cannot be directly synthesized. In 2010, the Chinese hypertension prevention and control guideline defined plasma Hcy concentration of 10. m u.mol/ L as hyperhomocysteinemia HHcy. A large number of epidemiological investigations and clinical trials show that mild to moderate Hcy elevation is one of the important factors in vascular ischemic diseases, independent of traditional risk factors for arteriosclerosis. Objective: To study the correlation between plasma homocysteine level and carotid atherosclerosis and stenosis degree. Methods: 495 patients were enrolled in the geriatrics department of the Second Hospital of Jilin University from December 2015 to November 2016, and 495 patients with carotid color Doppler ultrasound were used as research subjects. Among them, 205 males and 290 males were females, with an average age of 64. 92 and 9. 16 years. The patients with carotid thrombosis associated with the same type of cysteine metabolism, except cardiogenic and other causes, excluded from the group B vitamins, folic acid, and contraceptives, excluded cardiopulmonary and renal function failure and thyroid dysfunction. All enrolled patients were admitted to the hospital to collect fasting cubitus venous blood, determine blood routine, liver function, blood lipid, renal function, blood glucose and homocysteine and so on. The carotid artery color Doppler ultrasound was used to examine the thickness of carotid artery (IMT), plaque formation and plaque properties, and the carotid atherosclerosis and stenosis degree of patients were evaluated. The correlation between plasma Hcy level and carotid atherosclerosis and stenosis degree was studied by using single factor analysis of variance to compare plasma Hcy level between the four groups. The correlation between other factors and carotid atherosclerosis was analyzed by non-linear regression analysis. Finally, multivariate linear regression analysis was used to determine which factors were the independent risk factors for predicting carotid atherosclerosis. All the data were treated with SPSS22. 0 software package. All the results were statistically significant with P0.05. Results: The proportion of patients with carotid atherosclerosis was significantly higher than that in control group (P <0.05). The plasma Hcy level in atherosclerotic group was significantly higher than that in control group (P <0.05). 棰堝姩鑴夌播鏍风‖鍖栧悇缁勪箣闂磋娴咹cy姘村钩姣旇緝鍙戠幇,IMT澧炲帤缁勬枒鍧楀舰鎴愮粍涓噸搴︾嫮绐勭粍,鍚勭粍涔嬮棿宸紓鍧囨湁缁熻瀛︽剰涔，
本文编号：2312683
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