摘要
目的研究短暂性脑缺血发作(TIA)患者血清同型半胱氨酸(Hcy)、载脂蛋白(Apo)A1、Apo B水平及其临床意义。方法选取唐山中心医院2021-01—2023-10收治的112例TIA患者为TIA组,并纳入同时期来院健康体检者60例为对照组,均检测血清Hcy、Apo A1、Apo B水平,对比2组研究对象血清指标的差异,并分析血清指标与颈动脉内膜中层厚度(IMT)的关系;进一步根据随访7 d内TIA组是否进展为缺血性脑卒中(IS)分为IS组(发生IS,n=29例)与nIS组(未发生IS,n=83例),采用Logistic回归分析判断各指标与IS的关系。结果TIA组Hcy(17.53±4.34)μmol/L及Apo B(0.84±0.17)g/L,均明显高于对照组的(8.58±1.24)μmol/L、(1.32±0.25)g/L,Apo A1(1.26±0.39)g/L,明显低于对照组的(1.01±0.22)g/L(t=15.617、14.898、4.586,P<0.05)。Pearson相关性分析显示Hcy、Apo B水平与IMT均呈正相关(r=3.248、3.054,P<0.05),Apo A1与IMT呈负相关(r=-2.874,P<0.05)。IS组与nIS组相比,IS组合并高血压比例、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、IMT、Hcy、Apo A1、Apo B水平相比差异均有统计学意义(P<0.05)。Logistic回归分析显示,除IMT外,Hcy、Apo B及Apo A1也可作为影响IS的独立因素(P<0.05)。结论相较于健康人群,TIA患者血清Hcy、Apo B明显升高,Apo A1明显降低,其与患者IMT及病情进展IS风险密切相关,临床可通过检测上述指标为TIA病情评估提供可靠依据。
Objective To study serum homocysteine(Hcy),apolipoprotein(Apo)A1 and ApoB levels in patients with transient ischemic attack(TIA)and their clinical significance.Methods A total of 112 patients with TIA(TIA group)who were admitted to Tangshan Central Hospital from January 2021 to October 2023,and 60 healthy individuals(control group)who received health check-ups in the hospital during the same period were included.Serum Hcy,ApoA1 and ApoB levels were compared between the two groups.The relationship between serum indices and carotid intima-media thickness(IMT)was analyzed.According to whether TIA progressed to ischemic stroke(IS)within 7 days,patients with TIA were divided into IS group(29 patients with IS)and nIS group(83 patients without IS).Logistic regression analysis was conducted to identify the influencing factors for IS.Results The levels of Hcy and ApoB in the TIA group((17.53±4.34)μmol/L and(0.84±0.17)g/L)were significantly higher than those in control group((8.58±1.24)μmol/L and(1.32±0.25)g/L),ApoA1 level((1.26±0.39)g/L)in the TIA group was significantly lower than that((1.01±0.22)g/L)in control the group(t=15.617,14.898,4.586,respectively,P<0.05).Pearson correlation analysis showed that the levels of Hcy and ApoB were positively correlated with carotid IMT(r=3.248,3.054,P<0.05),and ApoA1 was negatively correlated with IMT(r=-2.874,P<0.05).The proportion of patients with hypertension,low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),IMT,Hcy,ApoA1 and ApoB levels showed statistically significant differences between the IS group and the nIS group(P<0.05).Logistic regression analysis showed that IMT,Hcy,ApoB and ApoA1 were independent factors for IS(P<0.05).Conclusion Compared with healthy individuals,serum Hcy and ApoB levels in patients with TIA are significantly higher,and ApoA1 level is significantly lower.Above indices are closely related to IMT and disease progression.Clinically,testing these indices can provide a reliable basis for evaluating the condition of TIA.
作者
骆艳伟
邹双骏
孙正芹
马亚新
LUO Yanwei;ZOU Shuangjun;SUN Zhengqin;MA Yaxin(Tangshan Central Hospital,Tangshan 063000,China)
出处
《中国实用神经疾病杂志》
2025年第2期228-232,共5页
Chinese Journal of Practical Nervous Diseases
基金
河北省2021年度医学科学研究课题计划资助项目(编号:20211633)。
