中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2013, Vol. 8 ›› Issue (31): 2923-2931.doi: 10.3969/j.issn.1673-5374.2013.31.005

• 原著:脑损伤修复保护与再生 • 上一篇    下一篇

高同型半胱氨酸伴血脂异常对脑卒中发生的协同作用

  

  • 收稿日期:2013-08-19 修回日期:2013-10-17 出版日期:2013-11-05 发布日期:2013-11-05
  • 基金资助:

    科技部医药卫生科学数据共享网(2005DKA32403)《老年流行病学数据集的建立》；军队医药卫生科研基金(11BJZ32)《老年人群食物不耐受的危害调查及早期预警和防治体系研究》；军队医药卫生科研基金(12BJZ271)《保健人群心脑血管病临床数据库构建》。

Synergistic effects of elevated homocysteine level and abnormal blood lipids on the onset of stroke

Lu Hao1, Liming Chen1, Xiaoyong Sai2, 3, Zhefeng Liu1, Guang Yang1, Rongzeng Yan1, Lili Wang1, Caiyun Fu1, Xuan Xu1, Zhenzhen Cheng1, Qiang Wu1, Shuzhang Li1   

  1. 1 Chinese PLA General Hospital, Beijing 100853, China
    2 Institute of Geriatrics, Chinese PLA General Hospital, Beijing 100853, China
    3 Beijing Key Laboratory of Geriatrics, Beijing 100853, China
  • Received:2013-08-19 Revised:2013-10-17 Online:2013-11-05 Published:2013-11-05
  • Contact: Shuzhang Li, Master, Chief physician, Chinese PLA General Hospital, Beijing 100853, China, saixiaoyong@163.com.
  • About author:Lu Hao, Master, Attending physician. Lu Hao, Liming Chen and Xiaoyong Sai contributed equally to this paper.

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摘要：

高同型半胱氨酸血症和血脂异常均为脑卒中的独立危险因素。那么，高同型半胱氨酸与血脂异常是否能对脑卒中的发生产生协同促进作用？鉴于此，选取脑卒中住院患者2089例及单纯椎间盘突出患者2089例的资料进行回顾性分析，两组患者进行1:1配对。文章采用配对Logistic模型对两组病例资料进行多因素分析。发现在考虑了患者年龄、性别、家族史、既往史、临床生化指标诸多因素的影响后，可判定同型半胱氨酸与脑卒中的发生相关；进一步考虑了患者年龄、性别、吸烟、饮酒、体质量指数、收缩压、家族高血压史、脑卒中史、冠心病史、既往高血压史、冠心病史因素的影响后分析发现，与同型半胱氨酸和血脂均正常的患者比较，血脂异常同时伴有高同型半胱氨酸患者的OR(95%CI)为1.409(1.127-1.761)，患脑卒中的风险增加40.9%。结果提示，高同型半胱氨酸与血脂异常可能对脑卒中的发生具有协同促进作用。高同型半胱氨酸同时伴血脂异常者更易患脑卒中。

关键词: 神经再生, 脑损伤, 卒中, 半胱氨酸, 危险因素, 病例对照研究, 血脂异常, 药物疗法, 联合, 住院患者, 心血管疾病, 配对分析, 基金资助文章

Abstract:

Hyperhomocysteinemia and abnormal blood lipids are independent risk factors for stroke. However, whether both factors exert a synergistic effect in the onset of stroke remains unclear. The present study is a retrospective analysis of 2 089 cases of stroke and 2 089 control cases of simple inter-vertebral disk protrusion using a paired multivariate logistic regression method. Adjusting for known confounding variables including the patients’ age, gender, smoking status, alcohol consumption status, patient and family medical history, and clinical biochemical indices, elevated homocysteine level was related to the onset of stroke. Patients with elevated homocysteine levels and abnormal blood lipids showed a 40.9 % increase in the risk for stroke compared to patients with normal homocysteine levels and blood lipids (odds ratio 1.409; 95% confidence interval 1.127–1.761). These results indicate that elevated homocysteine and abnormal blood lipids exert synergistic ef-fects in the onset of stroke. Patients with elevated homocysteine levels and abnormal blood lipids are predisposed to stroke.

Key words: neural regeneration, stroke, cysteine, risk factor, case-control study, abnormal blood lipids, medication, inpatients, cardiovascular disease, paired analysis, grants-supported paper, neuroregeneration