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目的:分析伴同型半胱氨酸(Hcy)增高的缺血性卒中患者(IS)的相关危险因素。方法:共纳入80例经头颅MRI/CT证实的且Hcy水平>20μmol/L的IS患者,同时随机抽取138例不伴Hcy增高的IS患者作为对照组。所有受试者均记录IS的传统危险因素。先以单因素分析筛选出有统计学意义的危险因素,再应用多因素非条件Logistic回归分析伴Hcy增高的IS患者的独立危险因素。结果:单因素分析表明:生活规律及高密度脂蛋白(HDL)与伴Hcy增高的IS患者呈负相关(P<0.05);男性、高血压病史、糖尿病史、家族卒中病史、冠心病病史、吸烟史、饮酒史、入院首次收缩压、C反应蛋白(CRP)及LDL与之呈正相关(P<0.05)。多因素分析表明:高血压病史、糖尿病史、吸烟史、CRP及LDL是伴Hcy增高的IS患者的独立危险因素;而生活规律是伴Hcy增高的IS患者的保护因素。结论:伴Hcy增高的IS患者的保护因素是生活规律,其独立危险因素是高血压病史、糖尿病史、吸烟史、CRP及LDL,对该类人群的高血压、糖尿病等危险因素进行必要的干预具有重要的意义。
PURPOSE: To analyze the associated risk factors for ischemic stroke (IS) with elevated homocysteine (Hcy). Methods: Eighty IS patients confirmed by MRI and CT scintigraphy and with Hcy level> 20μmol / L were enrolled in the study. At the same time, 138 patients with IS without Hcy elevation were enrolled as the control group. All subjects recorded conventional risk factors for IS. First univariate analysis of screening out statistically significant risk factors, and then using multivariate non-conditional Logistic regression analysis with ISH patients with elevated Hcy independent risk factors. Results: Univariate analysis showed that there was a negative correlation between lifestyle and high density lipoprotein (HDL) and IS patients with elevated Hcy (P <0.05); men, history of hypertension, history of diabetes, family history of stroke, history of coronary heart disease, Smoking history, drinking history, admission first systolic blood pressure, C-reactive protein (CRP) and LDL were positively correlated (P <0.05). Multivariate analysis showed that the history of hypertension, history of diabetes, smoking history, CRP and LDL were independent risk factors of IS patients with elevated Hcy, while life pattern was the protective factor of IS patients with elevated Hcy. CONCLUSION: The protective factor of IS patients with elevated Hcy is the law of life. The independent risk factors are history of hypertension, history of diabetes, history of smoking, CRP and LDL, and necessary interventions for such risk factors as hypertension and diabetes It is of great significance.