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目的探讨脑梗死发生与同型半胱氨酸(Hcy)及血脂水平的相关性,为防制脑梗死提供参考。方法纳入2 525例脑梗死住院患者及8 151名体检正常者为研究对象,采集研究对象清晨空腹静脉血,分别采用酶循环法和酶法进行血清Hcy和血脂水平检测,根据血脂检测结果计算动脉硬化指数(ASI),采用Logistic回归模型分析脑梗死发生的危险因素。结果正常组男性4 952人,女性3 199人,平均(45.65±10.77)岁;脑梗死组男性1 590例,女性935例,平均(65.47±12.16)岁。正常组共检出高Hcy血症360人,检出率为4.42%,脑梗死组共检出高Hcy血症268人,检出率为10.61%,差异有统计学意义(P<0.01)。Logistic回归分析结果显示,高龄(OR=1.147,95%CI:1.140~1.154)、高Hcy(OR=1.022,95%CI:1.010~1.035)、高总胆固醇(OR=2.815,95%CI:2.603~3.045)、高ASI(OR=1.914,95%CI:1.794~2.042)是脑梗死发生的危险因素,女性(OR=0.694,95%CI:0.606~0.697)是脑梗死发生的保护因素。结论血清Hcy、总胆固醇水平及ASI升高可增加脑梗死的发生风险,定期检测血清Hcy及血脂水平有助于及早发现和预防脑梗死。
Objective To investigate the correlation between the occurrence of cerebral infarction and homocysteine (Hcy) and blood lipid levels, and to provide a reference for the prevention of cerebral infarction. Methods A total of 2 525 hospitalized patients with cerebral infarction and 8 151 healthy subjects were enrolled in the study. Fasting venous blood samples were collected from the study subjects. Serum Hcy and lipids levels were measured by enzymatic and enzymatic methods respectively. Arterial Sclerotic index (ASI), the use of Logistic regression model analysis of risk factors for cerebral infarction. Results There were 4 952 males and 3 199 females in the normal group, with an average of (45.65 ± 10.77) years old. There were 1 590 males and 935 females with a mean of (65.47 ± 12.16) years. A total of 360 patients with high Hcy hyperlipidemia were detected in the normal group, with a detection rate of 4.42%. A total of 268 HH patients were detected in the cerebral infarction group, with a detection rate of 10.61%. The difference was statistically significant (P <0.01). Logistic regression analysis showed that high Hcy (OR = 1.022, 95% CI: 1.010-1.035), high total cholesterol (OR = 2.815, 95% CI: 2.603 ~ 3.045). High ASI (OR = 1.914, 95% CI: 1.794 ~ 2.042) was a risk factor for cerebral infarction. Female (OR = 0.694, 95% CI: 0.606-0.697) was the protective factor of cerebral infarction. Conclusions Serum Hcy, total cholesterol and ASI may increase the risk of cerebral infarction. Regular detection of serum Hcy and blood lipid level may be helpful for the early detection and prevention of cerebral infarction.