青年患者血清同型半胱氨酸水平与急性缺血性卒中的关系:孟加拉国一家最大的医学院医院的经验

Mohammad Nur Uddin, Maliha Hakim, Tahira Zannat, Md Al Amin, Mohammad Abdur Rauf Dolan, Md Abdullah Yusuf, Mashfiqul Hasan, Muhammad Saiful Islam, Swapon Kumar Ray, Md Faizul Islam Chowdhury
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摘要

背景:高同型半胱氨酸血症正在成为中风的一个可能的危险因素,可能是因为动脉粥样硬化加速。目的:本研究旨在评估孟加拉国年轻患者血清同型半胱氨酸水平与缺血性卒中之间的关系。方法:本横断面研究于2015年1月至2015年12月在达卡医学院附属医院医学部对18至40岁的急性局灶性神经功能障碍症状和体征的患者进行研究。病史记录和体格检查在预先设计的资料收集表中完成。然后进行脑ct扫描、空腹血清同型半胱氨酸、空腹血糖、2小时ABF血糖、糖化血红蛋白、空腹血脂等检查。结果:96例患者完成脑显像后发现缺血性脑卒中61例(65.0%)。正常同型半胱氨酸74例,中度高同型半胱氨酸血症17例,中度高同型半胱氨酸血症5例。缺血性脑卒中患者的空腹血清同型半胱氨酸平均水平(16.02 μmol/L, 95% CI: 12.87 ~ 19.87)明显高于非缺血性脑卒中患者(10.47 μmol/L, 95% CI: 9.16 ~ 11.95, P<0.001)。Logistic回归显示,空腹同型半胱氨酸是重要的独立危险因素,调整后OR为1.1 (95% CI: 1.1 ~ 1.2;p=0.04966),同型半胱氨酸每增加1 μmol/L。结论:同型半胱氨酸升高与缺血性脑卒中风险的关系是强的、分级的、显著的。孟加拉国国家神经科学研究所杂志,2023年1月;9(1):24-29
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Association of Serum Homocysteine Level with Acute Ischaemic Stroke among Young Adult Patients: Experience at a Largest Medical College Hospital in Bangladesh
Background: Hyperhomocysteinemia is emerging as a possible risk factor for stroke, possibly because of accelerated atherosclerosis. Objectives: This study was conducted to evaluate the association between the serum homocysteine level and ischemic stroke in young Bangladeshi patients. Methodology: This cross-sectional study was carried out among patients 18 to 40 years of either gender with sign and symptoms of acute focal neurological deficit, in the Department of Medicine of Dhaka Medical College Hospital, Dhaka, from January 2015 to December 2015. History taking and physical examination were done in a predesigned data collection sheet. Then required investigations like CT-scan of brain, fasting serum homocysteine, fasting blood sugar, 2 hours ABF blood glucose, HbA1c and fasting lipid profile were done. Results: Out of 96 patients after completing brain imaging 61(65.0%) patients were found suffering from ischemic stroke. Among the patients 74 had normal homocysteine level, 17 patients had moderate hyperhomocysteinemia and 5 patients had intermediate hyperhomocysteinemia. Mean levels of fasting serum homocysteine were significantly higher in patients those had ischemic stroke (16.02 μmol/L, 95% CI: 12.87 to 19.87) compared with those who did not have ischemic stroke (10.47 μmol/L, 95% CI: 9.16 to 11.95, P<0.001). Logistic regression showed fasting homocysteine as an important independent risk factor, with an adjusted OR of 1.1 (95% CI: 1.1 to 1.2; p=0.04966) for every 1 μmol/L increase in homocysteine. Conclusion: The relationship between increasing homocysteine and ischemic stroke risk is strong, graded, and significant. Journal of National Institute of Neurosciences Bangladesh, January 2023;9(1):24-29
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