本文選題：同型半胱氨酸 + 頸動(dòng)脈斑塊��； 參考：《中國(guó)慢性病預(yù)防與控制》2016年01期

【摘要】：目的探討影響腦卒中高危人群同型半胱氨酸(Hcy)與頸動(dòng)脈斑塊的危險(xiǎn)因素以及兩者的相關(guān)性,為社區(qū)開展腦卒中高危人群防治提供依據(jù)。方法于2014年10月采用單純隨機(jī)抽樣方法抽取上海市嘉定區(qū)徐行鎮(zhèn)小廟村55歲以上戶籍人口1561人,依據(jù)《腦卒中高危人群篩查和干預(yù)試點(diǎn)項(xiàng)目管理辦法(試行)》中規(guī)定,8項(xiàng)危險(xiǎn)因素占3項(xiàng)以上或既往有卒中或短暫性腦缺血發(fā)作病史者確定為腦卒中高危人群,共595人。剔除未參加體檢68人和可能影響數(shù)據(jù)結(jié)果的卒中或短暫性腦缺血發(fā)病史者107人,共獲得420人完整體檢數(shù)據(jù)。采用前進(jìn)法,以是否有高同型半胱氨酸血癥(HHcy)、頸動(dòng)脈班塊為因變量,單因素分析結(jié)果中與血漿Hcy、頸動(dòng)脈斑塊存在相關(guān)的危險(xiǎn)因子為自變量,進(jìn)行二分類賦值后作多因素logistic回歸分析。結(jié)果單因素分析顯示,研究人群中男性、年齡高、吸煙史和缺乏運(yùn)動(dòng)是血漿Hcy濃度升高的危險(xiǎn)因素(P0.01,P0.05),而年齡高、高血壓、糖尿病、缺乏運(yùn)動(dòng)、低密度脂蛋白膽固醇(LDL-C)異常和高Hcy是頸動(dòng)脈斑塊形成的危險(xiǎn)因素(P0.01,P0.05);多因素logistic回歸分析顯示,年齡(OR=1.126,95%CI:1.087~1.167)、性別(OR=0.165,95%CI:0.103~0.264)、糖尿病(OR=0.580,95%CI:0.345~0.976)與HHcy相關(guān)。男性血漿Hcy濃度[(19.00±10.15)μmol/L]高于女性[(15.22±5.64)μmol/L],且隨年齡增長(zhǎng)Hcy濃度升高。年齡、患糖尿病和LDL-C異常與頸動(dòng)脈斑塊形成相關(guān),Hcy及其他危險(xiǎn)因素被排除。結(jié)論社區(qū)開展腦卒中高危人群防治,應(yīng)重視和控制好血漿Hcy與血脂水平,以減緩頸動(dòng)脈斑塊的形成。
[Abstract]:Objective to investigate the risk factors and correlation between homocysteine cysteine (Hcyn) and carotid plaque in high risk population of stroke, and to provide evidence for prevention and treatment of high risk population of stroke in community. Methods in October 2014, a total of 1561 residents aged 55 and over were selected from Xiao Miao Village, Xuhang Zhen, Jiading District, Shanghai, using a simple random sampling method. According to the Management method of the pilot Project on screening and intervention of Stroke High risk population (trial), 595 people (595) were identified as the high risk group of stroke, according to the regulation that 8 risk factors accounted for more than 3 items or had a history of stroke or transient ischemic attack in the past. A total of 420 complete physical examination data were obtained by excluding 68 persons who did not participate in the physical examination and 107 patients who had a history of stroke or transient cerebral ischemia that might affect the results of the physical examination. The forward method was used to determine whether there was hyperhomocysteinemia and carotid artery block as dependent variables. The results of univariate analysis showed that the risk factors associated with plasma Hcyand carotid plaque were independent variables. The multivariate logistic regression analysis was performed after the two classification values were assigned. Results the univariate analysis showed that male, age, smoking history and lack of exercise were the risk factors for the increase of plasma Hcy concentration, while the elderly, hypertension, diabetes, and lack of exercise. Low density lipoprotein cholesterol (LDL-C) abnormality and high Hcy were the risk factors of carotid plaque formation (P 0.01) and multivariate logistic regression analysis showed that age OR 1.126% 95% CI: 1.0871.167%, sex ORO 0.165% 95% CIW 0.103 0.264, diabetes ORO 0.58095CIW 0.345C 0.976) were associated with HHcy. The plasma Hcy concentration in males [19.00 鹵10.15 渭 mol/L] was higher than that in females [15.22 鹵5.64 渭 mol/L], and the concentration of Hcy increased with age. Age, diabetes and LDL-C abnormalities were excluded from carotid plaque formation associated with homocysteine and other risk factors. Conclusion in order to slow down the formation of carotid plaque, the community should pay attention to and control plasma Hcy and blood lipids in order to prevent and treat the high risk population of cerebral apoplexy.
【作者單位】： 嘉定區(qū)徐行鎮(zhèn)社區(qū)衛(wèi)生服務(wù)中心預(yù)防科;嘉定區(qū)疾病預(yù)防控制中心慢病科;第二軍醫(yī)大學(xué)衛(wèi)生事業(yè)管理學(xué)教研室;
【分類號(hào)】：R743.3

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