脑白质疏松患者肾功能不全与血浆同型半胱氨酸的相关性研究

摘要

Objective To examine the relationship of the level of plasma Hcy with renal dysfunction in patients with leukoaraiosis (LA). Methods According to the renal function, the patients were divided into renal dysfunction group (n=112) and normal control group (n=74). Demographic information such as sex, age, and past history were collected. The blood Cr, BUN, UA, Hcy, HbA1c, TC, LDL-C were measured. The degree of LA was measured by Fazekas scale according to MRI imaging. Results A total of 186 patients with LA were enrolled in this study. (1) The BUN (P=0.001), Cr (P=0.000), UA (P=0.000) and Hcy levels in renal dysfunction group were signiflcantly higher than those in control group (P=0.000), and the Fazekas score was signiflcantly higher than that of control group (P=0.04). (2) The correlation analysis showed that plasma Hcy level were positively correlated with the Fazekas score (r=0.202, P=0.027), the level of blood Cr (r=0.458, P=0.000), UA (r=0.229, P=0.010) and BUN (r=0.178,P=0.046). (3) Multivariate logistic regression analysis showed that plasma Hcy level ( OR 4.165, 95% CI 1.138-15.249, P=0.031) was an independent risk factor of renal dysfunction in patients with LA . Conclusions Plasma Hcy level may be an independent risk factor of renal dysfunction in patients with LA, and renal dysfunction may be involved in the development of LA by affecting blood Hcy level.%目的 探讨脑白质疏松(leukoaraiosis,LA)合并肾功能不全与血浆Hcy水平的相关性.方法 选取LA患者作为研究对象,依据病史及肾功能检测指标将患者分为肾功能不全组(观察组)和肾功能正常组(对照组).记录患者Cr、BUN、UA、Hcy、HbA1c、TC、LDL-C等生化指标水平,并以Fazekas评分量表完成LA严重程度评分.对比2组生化指标水平,并对肾功能不全的可能影响因素进行多因素分析.对生化指标、肾功能及LA进行相关性分析.结果 共入组186例患者,其中对照组112例,观察组74例.①与对照组相比,观察组BUN水平(P=0.001)、Cr水平(P=0.000)、UA水平(P=0.000)、Hcy水平(P=0.000)升高,差异有统计学意义;观察组Fazekas评分较对照组升高,差异有统计学意义(P=0.04);②相关分析显示,血浆Hcy水平与Fazekas总评分(r=0.202,P=0.027)、Cr水平(r=0.458,P＜0.001)、UA水平(r=0.229, P=0.010)、BUN水平(r=0.178,P=0.046)正相关;③多因素Logistic回归分析显示,Hcy(OR?4.165, 95%Cl?1.138～15.249,P=0.031)是LA患者肾功能不全的危险因素.结论 Hcy是LA患者肾功能不全的危险因素,肾功能不全可能通过影响血浆Hcy水平从而参与LA的发生发展.