2020 年第 8 期 第 15 卷

血清趋化素及同型半胱氨酸水平与缺血性脑血管病患者血管狭窄程度的相关性研究

Correlation between chemerin, homocysteine levels and ischemic cerebrovascular disease

作者：王丽轩洪震张乐国贾建普张俊玲

英文作者：Wang Lixuan Hong Zhen Zhang Leguo Jia Jianpu Zhang Junling

单位：河北省沧州市中心医院脑科医院神经内科061001

英文单位：Department of Neurology Brain Hospital Cangzhou Central Hospital Hebei Province Cangzhou 061001 China

关键词：缺血性脑血管病；趋化素；同型半胱氨酸

英文关键词：chemiccerebrovasculardisease;Chemokine;Homocysteine

• 摘要：

• 目的 探讨血清趋化素及同型半胱氨酸（Hcy）水平与缺血性脑血管病（IVCD）患者血管狭窄程度的相关性。方法 选择 2017年 1月至2019年1月于河北省沧州市中心医院神经内科完成数字减影脑血管造影检查的ICVD患者60例，按照检查结果选取颅内、外脑大动脉至少1支血管狭窄率≥50%者30例为中重度狭窄组，颅内、外脑大动脉血管狭窄率＜50%者30例为轻度狭窄组，选取同期到本院健康体检者30名作为对照组。观察各组脂质代谢水平水平［总胆固醇、三酰甘油、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）］和趋化素及Hcy水平；记录高Hcy血症发生情况；分析趋化素与高Hcy血症发生率的相关性；分析趋化素及Hcy与脂质代谢水平的相关性。结果 中重度狭窄组血清趋化素、Hcy水平明显高于轻度狭窄组，且中重度狭窄组、轻度狭窄组血清趋化素、Hcy水平明显高于对照组［（119±15）、（91±16）μg/L比（77±13）μg/L；（14.6±2.9）、（9.3±2.0）μmol/L比（7.0±1.9）μmol/L］，3组间比较差异均有统计学意义（均P＜0.05）。中重度狭窄组总胆固醇、三酰甘油、LDL-C水平均高于轻度狭窄组，HDL-C水平低于轻度狭窄组；中重度狭窄组、轻度狭窄组总胆固醇、三酰甘油、LDL-C水平均高于对照组，HDL-C水平低于对照组，3组间比较差异均有统计学意义（均P＜0.05）。中重度狭窄组高Hcy血症发生率明显高于轻度狭窄组［76.7%（22/30）比53.3%（16/30）］，差异有统计学意义（P＜0.05）。IVCD患者血清趋化素水平与高Hcy血症发生率呈正相关（r=0.474，P=0.001）。血清趋化素及Hcy水平与总胆固醇、三酰甘油、HDL-C及LDL-C均呈正相关（均P＜0.05）。结论 血清趋化素及Hcy水平与缺血性脑学管病患者血管狭窄程度密切相关。

• Objective To investigate the correlation between serum chemerin ， homocysteine (Hcy) and ischemic cerebrovascular disease (IVCD). Methods Sixty patients with ICVD who underwent digital subtraction angiography (DSA) admitted to department of Neurology, Cangzhou Central Hospital from January 2017 to January 2019 were enrolled. According to the DSA Results , patients with intracranial and extracranial aorta ≥1 vascular stenosis ≥50% (30 cases) were in the stenosis group； patients with arterial stenosis ＜50% (30 cases) were in the mild stenosis group； 30 healthy subjects were as the control group. The changes of lipid metabolism levels ［total cholesterol, triacylglycerol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C)］, Chemerin and Hcy in each group were observed. The occurrence of hyperhomocysteinemia was recorded. The correlation among chemokine, the incidence of hyperhcy, chemokine, Hcy and lipid metabolism was analyzed. Results The levels of serum chemokine and Hcy in the moderate and severe stenosis group were significantly higher than those in the mild stenosis group; the levels of serum chemokine and Hcy in the moderate and severe stenosis group were significantly higher than those in the control group［（119±15）,（91±16）μg/L vs （77±13）μg/L；（14.6±2.9）,（9.3±2.0）μmol/L vs （7.0±1.9）μmol/L］; and the differences were statistically significant (all P＜0.05). The levels of total cholesterol, triglyceride and LDL-C in the moderate and severe stenosis group were higher than those in the mild stenosis group; the levels of HDL-C in the moderate and severe stenosis group were lower than those in the mild stenosis group; the levels of total cholesterol, triglyceride and LDL-C in the moderate and severe stenosis group were higher than those in the control group (all P＜0.05). The incidence of Hcy in moderate and severe stenosis group was significantly higher than that in mild stenosis group ［76.7%(22/30) vs 53.3%(16/30) ，P＜0.05］. There was a positive correlation between serum chemokine and Hcy (r=0.474, P=0.001). The levels of serum chemokine and Hcy were positively correlated with total cholesterol, triacylglycerol, HDL-C and LDL-C (all P＜0.05). Conclusions erum Chemerin and Hcy levels are closely related to the degree of ischemic cerebrovascular stenosis.