脑梗死复发患者血清同型半胱氨酸、白蛋白和尿微量白蛋白的变化及其影响因素分析

目的:研究脑梗死复发患者血清同型半胱氨酸(Hcy)、白蛋白(ALB)和尿微量白蛋白的变化及脑梗死复发的影响因素。方法:将2013年2月至2016年2月我院收治的脑梗死复发患者63例记为复发组,另取同期住院治疗的未复发脑梗死患者57例记为非复发组。比较两组患者血清Hcy、ALB、尿微量白蛋白水平和基本资料,并采用多因素Logistic回归分析脑梗死复发的影响因素。结果:复发组血清Hcy、尿微量白蛋白水平高于非复发组,复发组血清ALB水平低于非复发组(P0.05)。经Pearson相关性分析可得:脑梗死复发患者血清Hcy与尿微量白蛋白水平呈正相关关系,ALB与Hcy、尿微量白蛋白水平呈负相关关系(P0.05)。复发组高血压、脑白质疏松、脑血管病家族史人数占比高于非复发组(均P0.05)。经多因素Logistic回归分析可得:血清Hcy、尿微量白蛋白水平以及高血压均是脑梗死复发的独立危险因素(P0.05),而血清ALB水平是脑梗死复发的保护性因素(P0.05)。结论:脑梗死复发患者的血清Hcy、尿微量白蛋白水平升高,而血清ALB水平降低,上述三项指标的异常改变可能共同促进了脑梗死的复发,值得临床重点关注。

Changes of Serum Homocysteine, Albumin and Uric Microalbumin in Patients with Recurrent Cerebral Infarction and Analysis of Their Influence Factors

ABSTRACT Objective: To study the changes of serum homocysteine (Hcy), albumin (ALB) and urinary microalbumin in patients with recurrent cerebral infarction and the influence factors of cerebral infarction recurrence. Methods: 63 patients with recurrent cerebral infarction who were admitted to our hospital from February 2013 to February 2016 were enrolled as the recurrence group, and another 57 patients without recurrent cerebral infarction who were hospitalized during the same period were enrolled as the non-recurrence group. The serum Hcy, ALB and urinary microalbumin levels and basic data were compared between the two groups. Multivariate logistic regression was used to analyze the influence factors of recurrence cerebral infarction. Results: Serum Hcy and urinary microalbumin levels in the recurrence group were higher than those in the non-recurrence group. Serum ALB level in the recurrence group was lower than that in the non-recurrence group (P<0.05). Pearson correlation analysis showed that serum Hcy was positively correlated with urinary microalbumin level in patients with recurrent cerebral infarction, ALB was negatively correlated with Hcy and urinary microalbumin levels (P<0.05). The proportion of hypertension, leukoaraiosis and family history of cerebrovascular diseases in the recurrent group were higher than those in the non-recurrent group (all P<0.05). Multivariate Logistic regression analysis showed that serum Hcy, urinary microalbumin level and hypertension were independent risk factors for recurrence cerebral infarction (P<0.05), while serum ALB level was a protective factor for recurrence cerebral infarction (P<0.05). Conclusion: The levels of serum Hcy and urinary microalbumin in patients with recurrent cerebral infarction increased, while the levels of serum ALB decreased. The abnormal changes of these three indicators may promote the recurrence of cerebral infarction, which deserves clinical attention.