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目的探讨成人动脉粥样硬化性类烟雾病缺血性卒中的危险因素。方法选取缺血型动脉粥样硬化性类烟雾病患者(类烟雾病组)95例、健康志愿者(正常对照组)94例,检测所有对象血浆Hcy,同时记录所有对象的人口学、病史资料、临床数据,进行组间对比及Logistic回归分析。根据铃木分期,将类烟雾病患者分为烟雾血管逐渐形成组(铃木分期Ⅰ、Ⅱ期)、烟雾血管发展加重组(铃木分期Ⅲ期)、烟雾血管形状缩小组(铃木分期Ⅳ期)、烟雾血管逐渐消失组(铃木分期Ⅴ、Ⅵ期),比较4亚组间血浆Hcy水平,并进行统计学分析。结果 Logistic回归分析显示血浆Hcy、LDL水平升高,HDL水平下降是动脉粥样硬化性类烟雾病缺血性卒中的独立危险因素(P<0.05)。烟雾血管逐渐消失组血浆Hcy水平[(20.85±4.49)μmol/L]分别显著高于其余3亚组[(17.24±3.14)μmol/L]、[(17.98±4.07)μmol/L]、[(17.97±3.41)μmol/L](P<0.05),余各亚组间血浆Hcy水平差异无统计学意义(P>0.05)。结论 Hcy、LDL水平升高,HDL水平下降是动脉粥样硬化性类烟雾病缺血性卒中的独立危险因素。血浆Hcy水平与缺血型动脉粥样硬化性类烟雾病患者分期的严重程度有关。
Objective To investigate the risk factors of adult atherosclerotic moyamoya disease. Methods Ninety-five patients with ischemic atherosclerotic moyamoya disease (WMD) and 94 healthy volunteers (control group) were enrolled in this study. Plasma homocysteine (Hcy) levels were measured in all subjects. Demographic data and history data of all subjects , Clinical data, compared between groups and Logistic regression analysis. According to the Suzuki staging, the patients with moyamoya disease were divided into three groups: the progressive group of smoke and blood vessels (stage Ⅰ and Ⅱ of Suzuki), the group of aggravation of smoke and blood vessels (stage Ⅲ of Suzuki), the group of shrinking of smoke and blood vessels (stage Ⅳ of Suzuki) Blood vessels gradually disappeared (Suzuki staging Ⅴ, Ⅵ), plasma Hcy levels between the 4 subgroups were compared and statistically analyzed. Results Logistic regression analysis showed that plasma Hcy and LDL levels were elevated and HDL level was decreased as an independent risk factor for atherosclerotic moyamoya disease (P <0.05). The level of plasma Hcy in smoldering smog group [(20.85 ± 4.49) μmol / L] was significantly higher than that in the other three subgroups (17.24 ± 3.14 μmol / L, 17.98 ± 4.07 μmol / L, 17.97 ± 3.41) μmol / L] (P <0.05). There was no significant difference in plasma Hcy levels among all subgroups (P> 0.05). Conclusions Hcy and LDL levels are elevated and HDL level is decreased as an independent risk factor for atherosclerotic moyamoya disease. The level of plasma Hcy is related to the severity of stage of ischemic atherosclerotic moyamoya disease.