[1]国钰梅,马 龙,潘国涛,等.急性缺血性脑卒中患者同型半胱氨酸水平与出院结局的关联研究[J].现代检验医学杂志,2016,31(05):23-26,29.[doi:10.3969/j.issn.1671-7414.2016.05.006]
 GUO Yu-mei,MA Long,PAN Guo-tao,et al.Relationship between Homocysteine Levels in Patients with Acute Ischemic Stroke and Discharged Outcome[J].Journal of Modern Laboratory Medicine,2016,31(05):23-26,29.[doi:10.3969/j.issn.1671-7414.2016.05.006]
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急性缺血性脑卒中患者同型半胱氨酸水平与出院结局的关联研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第31卷
期数:
2016年05期
页码:
23-26,29
栏目:
论著
出版日期:
2016-10-21

文章信息/Info

Title:
Relationship between Homocysteine Levels in Patients with Acute Ischemic Stroke and Discharged Outcome
文章编号:
1671-7414(2016)05-023-05
作者:
国钰梅1马 龙1潘国涛2杨丽荣1白文婷1包成月1 金星灿1吕利英1佟伟军2周 蓦2李红美2许锬2
1.兴安盟人民医院,内蒙古自治区乌兰浩特 137400;
2.苏州大学流行病与卫生统计学教研室,江苏苏州 215123
Author(s):
GUO Yu-mei1MA Long1PAN Guo-tao2YANG Li-rong1BAI Wen-ting1BAO Cheng-yue1 JIN Xing-can1L(¨overU)Li-ying1TONG Wei-jun2ZHOU Mo2LI Hong-mei2XU Tan2
1.People's Hospital of Xing'an League,Inner Mongolia Ulanhot 137400,China;
2.Department of Epidemiology and Health Stutistics,Soochow University,Jiangsu Suzhou 215123,China
关键词:
同型半胱氨酸 急性缺血性脑卒中 出院 结局不良 风险
分类号:
R743.3; R446.112
DOI:
10.3969/j.issn.1671-7414.2016.05.006
文献标志码:
A
摘要:
目的 探讨入院时血浆同型半胱氨酸水平与急性缺血性脑卒中患者出院结局不良的关系。方法 采用回顾性队列研究的方法,连续性纳入1 319例急性缺血性脑卒中住院患者,按入院时血浆同型半胱氨酸水平分为3组,采用非条件logistic回归分析入院时血浆同型半胱氨酸水平与急性缺血性脑卒中出院结局不良的关系。结果 结局良好与结局不良组之间入院时血浆同型半胱氨酸水平差异有统计学意义(P<0.000 1)。以血浆同型半胱氨酸水平第1组为参比,第2,3组发生出院结局不良的OR值(95%CI)分别为2.111(1.297~3.437,P<0.05),2.113(1.361~3.279,P<0.05); 经多因素调整后,第2,3组仍有增加急性缺血性脑卒中出院结局不良的风险,OR值(95%CI)分别为1.876(1.160~3.036,P<0.05),2.396(1.414~4.062,P<0.05)。结论 入院时血浆同型半胱氨酸水平升高可增加急性缺血性脑卒中患者出院结局不良发生率的风险,是独立的危险因素,血浆同型半胱氨酸水平越高不良结局的风险越高。
Abstract:
Objective To investigate the relationship between plasma homocysteine on admission and the outcome at discharge of acute ischemic stroke.Methods A non-concurrent cohort study was performed and a total of 1 319 patients with acute ischemic stroke were continuously included in this study.According to tertile range of plasma homocysteine,patients were divided into three group.Logistic regression analysis was used to assess the independent association between plasma homocysteine on admission and poor outcome at discharge of acute ischemic stroke.Results The difference of plasma homocysteine on admission between the poor outcome and those with good outcome had statistical significance(P<0.000 1).Withoutthe adjustment of multiple factors,when comparing to the first group,the second and third tertile seemed to have a tendency of increasing the risk of poor outcome at discharge,the OR(95%CI)was 2.111(1.297~3.437,P<0.05),2.113(1.361~3.279,P<0.05).After adjustment for multivariate,the second and third tertile also seemed to have a tendency of increasing the risk of poor outcome at discharge,the OR(95%CI)was 1.876(1.160~3.036,P<0.05),2.396(1.414~4.062,P<0.05).Conclusion The current study indicated that higher plasma homocysteine level was an independent risk factor for poor outcome at discharge in ischemic stroke patients.It would increase the risk of the outcome at discharge in patients with acute ischemic stroke,and suggests that there is a dose-response relationship between plasma homocysteine level on admission and the poor outcome at discharge.

参考文献/References:

[1] Fan FF,Huo Y,Wang X,et al.Effect of enalapril on plasma homocysteine levels in patients with essential hypertension[J].Journal of ZhejiangUniversity Science B,2010,11(8):583-591.
[2] 闫福堂,于建平,袁 军,等.血清同型半胱氨酸与原发性高血压的关系研究[J].现代检验医学杂志,2013,28(5):50-52. Yan FT,Yu JP,Yuan J,et al.Relationship research on serum Hcy with essential hypertension[J].Journal of Modern Laboratory Medicine,2013,28(5):50-52.
[3] Eikelboom JW,Hankey GJ,Anand SS,et al.Association between high homocyst(e)ine and ischemic stroke due to large-and small-artery disease but not other etiologic subtypes of ischemic stroke[J].Stroke,2000,31(5):1069-1075.
[4] Martín-Herrero F,Martín-Moreiras J,Pabón P,et al.Homocysteine and outcome in young patients with acute coronary syndromes[J].International Journal of Cardiology,2007,118(2):183-188.
[5] Wald DS,Wald NJ,Morris JK,et al.Folic acid,homocysteine,and cardiovascular disease:judging causality in the face of inconclusive trial evidence[J].BMJ,2006,333(7578):1114-1117.
[6] 吴 雁,王白石. 缺血性脑卒中患者血清红细胞生成素与同型半胱氨酸水平改变及其意义[J]. 现代检验医学杂志,2014,29(5):117-119. Wu Y,Wang BS.Serum erythropoietin,homocysteine level change and its significance in ischemic stroke patients[J].Journal of Modern Laboratory Medicine,2014,29(5):117-119.
[7] 宋春霞,李亚军,张世俊,等.血同型半胱氨酸水平与缺血性脑卒中严重程度的关系[J].中风与神经疾病杂志,2011,28(6):547-548. Song CX,Li YJ,Zhang SJ,et al.Relationship between homocysteine levels in blood and severity of ischemic stroke[J].Journal of Apoplexy and Nervous Diseases,2011,28(6):547-548.
[8] Song IU,Kim JS,Ryu SY,et al.Are plasma homocysteine levels related toneurological severity and functional outcome after ischemic stroke in the Korean population?[J].Journal of the Neurological Sciences,2009,278(1/2):60-63.
[9] Stead LG,Gilmore RM,Bellolio MF,et al.Hypergly-cemia as an independent predictor of worse outcome in non-diabetic patients presenting with acute ischemic stroke[J].Neurocritical Care,2009,10(2):181-186.
[10] 陆 敏,赵红东,唐 冰.高Hcy血症与急性缺血性脑卒中复发相关性研究[J].脑与神经疾病杂志,2012,20(3):217-220. Lu M, Zhao HD, Tang B.Hyperhomocysteinemia and the recurrence of acuteischemic cerebral stroke[J].Journal of Brain and Nervous Diseases,2012,20(3):217-220.
[11] Lee M,Hong KS,Chang SC,et al.Efficacy of homocysteine-lowering therapy with folic acid in stroke prevention a meta-analysis[J].Stroke,2010,41(6):1205-1212.
[12] Wu XQ,Ding J,Ge AY,et al.Acute phase homocysteine related to severity and outcome of atherothrombotic stroke[J].European Journal of Internal Medicine,2013,24(4):362-367.
[13] 张伟丽,祝立新,孙 凯,等.高同型半胱氨酸水平与脑卒中患者心脑血管事件再发风险的关系[J]. 临床内科杂志,2009,26(10):666-668. Zhang WL,Zhu LX,Sun K,et al.Elevated plasma homocysteine levels contribute to the risk of secondary cardio-cerebrovascular disease in a large prospective stroke population[J].Journal of Clinical Internal Medicine,2009,26(10):666-668.
[14] Temple ME,Luzier AB,Kazierad DJ.Homocysteine as a risk factor for atherosclerosis[J].Annals of Pharmacotherapy,2000,34(1):57-65.
[15] Yang Q,Botto LD,Erickson JD,et al.Improvement in stroke mortality inCanada and the United States,1990 to 2002[J].Circulation,2006,113(10):1335-1343.
[16] Wang X,Qin X,Demirtas H,et al.Efficacy of folic acid supplementationin stroke prevention: a meta-analysis[J].The Lancet,2007,369(9576):1876-1882.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金(项目批准号:81172760)。
作者简介:国钰梅(1962-),女,本科学历,主任检验师,研究方向为临床医学检验,Tel:13847992738,E-mail:xamyygym@sina.com。
通讯作者:许 锬,E-mail:xutan@suda.edu.cn。
更新日期/Last Update: 2016-10-30