高同型半胱氨酸血症及卒中危险因素的研究-东南大学学报医学版

高同型半胱氨酸血症及卒中危险因素的研究

单位：1. 盐城市第一人民医院神经内科, 江苏盐城 224000;2. 东南大学附属中大医院神经内科, 江苏南京 210009

分类号：R743.1

出版年·卷·期（页码）：2012·31·第六期（732-735）

摘要：

目的:了解高同型半胱氨酸血症及卒中的危险因素,并探讨两者之间的关系。方法:收集441例急性脑梗死、脑出血患者及243例非卒中患者的临床资料,以Logistic回归方法分析高同型半胱氨酸血症及卒中的危险因素。结果:高同型半胱氨酸血症的危险因素主要是年龄、高血压、吸烟及男性(均P<0.05);卒中的危险因素主要是年龄、高血压、糖尿病、吸烟(均P<0.05)。结论:年龄、高血压、吸烟是高同型半胱氨酸血症和卒中共同的危险因素,三者均是动脉粥样硬化公认的危险因素,因此,高同型半胱氨酸血症可能与卒中一样,均是动脉粥样硬化的后续表现,而不是卒中的致病因素。

Objective: To investigate the risk factors of hyperhomocysteinemia and stoke and explore the assoiation between them. Methods: Four hundred and forty-one patients with acute cerbral infarction or hemorrhage and 243 patients without stroke were collected. Logistic regression was used to find the risk factors of hyperhomocysteinemia and stoke.Results:Age,hypertension,smoke and male were the risk factors of hyperhomocysteinemia.Age,hypertension,diabetes and smoke were the risk factors of stroke.Conclusion: Age,hypertension,smoke are the common risk factors of hyperhomocysteinemia and stoke,and they are all risk factors of arteriosclerosis.Hyperhomocysteinemia may occur after arteriosclerosis,just like stroke.

参考文献：

[1] McCULLY K S.Vascular pathology of homocysteinemia:implications for the pathogenesis of arteriosclerosis[J].Am J Pathol,1969,56:111-128.
[2] WALD D S,LAW M,MORRIS J K.Homocysteine and cardiovascular disease:evidence on causality from a meta-analysis[J].BMJ,2002,325:1202-1206.
[3] THE HOMOCYSTEINE STUDIES COLLABORATION.Homocysteine and risk of ischemic heart disease and stroke:a meta-analysis[J].JAMA,2002,288:2015-2022.
[4] WALD D S,WALD N J,LAW M,et al.Folic acid,homocysteine,and cardiovascular disease:judging causality in the face of inconclusive trial evidence[J].BMJ,2006,333:1114-1117.
[5] 赵玉芳,江晓津,鞠兴东,等.同型半胱氨酸与缺血性脑血管病的关系[J].现代医学,2003,31(5):296-298.
[6] 王桂红,王拥军,何耀,等.血浆同型半胧氨酸水平与脑大动脉粥样硬化性病变的相关性分析[J].中华内科杂志,2006,9:744-747.
[7] SBAROUNI E,KYRIAKIDES Z S,KREMASTINOS D T.The effect of hormone replacement therapy and simvastatin on plasma homocysteine[J].J Womens Health,2005,14:154-158.
[8] WOLLESEN F,BRATTSTROM L,REFUSUM H,et al.Plasma total homocysteine and cystieine in relation to glomerularfiltration rate in diabetes mellitus[J].Kidney Int,1999,55:1028-1035.
[9] MCCULLY K S.Homocysteine and vascular disease[J].Nat Med,1996,2(4):386-389.
[10] WELCH G N,LOSCALZO J N.Homocysteine and atherothrombosis[J].N Engl J Med,1998,338(15):1042-1050.
[11] FALLON U B,BEN-SHLOMO Y,ELWOOD P,et al.Homoeysteine and coronary heart disease in the Caerphilly Cohort:a 10 year folIow up[J].Heart,2001,85:153-158.
[12] LOSCALZO J.Homocysteine trials-clear outcomes for complex reasons[J].N Engl J Med,2006,354:1629-1632.
[13] HANKEY G J.Is plasma homocysteine a modifiable risk factor for stroke?[J].Nat Clin Pract Neurol,2006,2:26-33.
[14] FURIE K L,KELLY P J.Homocysteine and stroke[J].Semin Neurol,2006,26:24-32.
[15] SELHUB J.The many facets of hyperhomocysteinemia:studies from the Framingham cohorts[J].J Nutr,2006,136(6 Suppl):1726S-1730S.
[16] BAZZANO L A,REYNOLDS K,HOLDER K N,et al.Effect of folic acid supplementation on risk of cardiovascular diseases:a meta-analysis of randomized controlled trials[J].JAMA,2006,296:2720-2726.
[17] TOOLE J F,MALINOW M R,CHAMBLESS L E,et al.Lowering plasma total homocysteine to prevent recurrent stroke,myocardial infarction,and death in ischemic stroke patients:results of the vitamin intervention for stroke prevention (VISP) Randomized Trial[J].JAMA,2004,291:565-575.
[18] LONN E,YUSUF S,ARNOLD M J,et al.Homocysteine lowering with folic acid and B vitamins in vascular disease[J].N Engl J Med,2006,354:1567-1577.
[19] BONAA K H,NJOLSTAD I,UELAND P M,et al.Homocysteine lowering and cardiovascular events after acute myocardial infarction[J].N Engl J Med,2006,354:1578-1588.
[20] ALBERT C M.Women's antioxidant and folic acid cardiovascular study[J].Clin Cardiol,2007,30:50.
[21] 高奋,李静梅,肖传实.高同型半胱氨酸血症兔模型动脉粥样硬化的形成[J].中国动脉硬化杂志,2002,10:348-349.
[22] 王宏利,樊东升,沈扬,等.颈动脉硬化症与高同型半胱氨酸血症关系的研究[J].中华内科杂志,2005,44:258-261.
[23] YOO J H,CHUNG C S,KAN S S.Relation of plasma homocysteine to cerebral infarction and cerebral atherosclerosis[J].Stroke,1998,29 (12):2478-2483.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录