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        高尿酸、高同型半胱氨酸血癥對腦梗死患者基底節(jié)鈣化發(fā)生的影響

        2020-05-07 02:00:43王麗萍劉秀萍張志剛趙志林張崢
        中國醫(yī)學創(chuàng)新 2020年3期
        關鍵詞:同型半胱氨酸血鈣尿酸

        王麗萍 劉秀萍 張志剛 趙志林 張崢

        【摘要】 目的:分析高尿酸、高同型半胱氨酸血癥(HHcy)對腦梗死患者基底節(jié)鈣化發(fā)生的影響。方法:回顧性分析本院2016年1月-2017年12月65例腦梗死患者的臨床資料,根據患者是否發(fā)生基底節(jié)鈣化,分為A組(無基底節(jié)鈣化)和B組(發(fā)生基底節(jié)鈣化)。比較兩組臨床基本資料、血清堿性磷酸酶(ALP)、血鈣、尿酸和同型半胱氨酸(Hcy)水平的差異。結果:65例患者中,發(fā)生基底節(jié)鈣化29例,發(fā)生率為44.62%;兩組性別、年齡、糖尿病、高血壓發(fā)生率比較,差異均無統計學意義(P>0.05);B組血清ALP水平明顯低于A組(P<0.05);兩組血鈣水平比較,差異無統計學意義(P>0.05);B組血清尿酸和Hcy水平均明顯高于A組,差異均有統計學意義(P<0.05)。結論:發(fā)生基底節(jié)鈣化的腦梗死患者可能伴有高尿酸、HHcy的臨床特征,且ALP可能參與基底節(jié)鈣化的發(fā)生。

        【關鍵詞】 腦梗死 基底節(jié)鈣化 堿性磷酸酶 血鈣 尿酸 同型半胱氨酸

        Effect of Hyperuricemia and Hyperhomocysteinemia on Basal Ganglia Calcification in Patients with Cerebral Infarction/WANG Liping, LIU Xiuping, ZHANG Zhigang, ZHAO Zhilin, ZHANG Zheng. //Medical Innovation of China, 2020, 17(03): -124

        [Abstract] Objective: To analyze the effect of hyperuricemia and hyperhomocysteinemia (HHcy) on basal ganglia calcification in patients with cerebral infarction. Method: The clinical data of 65 patients with cerebral infarction in our hospital from January 2016 to December 2017 were retrospectively analyzed. According to whether the patients had basal ganglia calcification, they were divided into group A (no basal ganglia calcification) and group B (basal ganglia calcification). The basic clinical data, serum alkaline phosphatase (ALP), serum calcium, uric acid and homocysteine (Hcy) levels were compared between the two groups. Result: Among the 65 patients, 29 cases had basal ganglia calcification, the incidence was 44.62%. There were no significant differences in gender, age, incidence of diabetes and hypertension between the two groups (P>0.05). The level of ALP in group B was significantly lower than that in group A (P<0.05). The blood calcium levels of the two groups were compared, the difference was not statistically significant (P>0.05). The levels of serum uric acid and Hcy in group B were significantly higher than those in group A, the differences were statistically significant (P<0.05). Conclusion: Cerebral infarction patients with basal ganglia calcification may have clinical features of hyperuricemia and HHcy, and ALP may be involved in the occurrence of basal ganglia calcification.

        [Key words] Cerebral infarction Basal ganglia calcification Alkaline phosphatase Blood calcium Uric acid Homocysteine

        First-authors address: Changping District Hospital of Traditional Chinese Medicine, Beijing 102200, China

        doi:10.3969/j.issn.1674-4985.2020.03.030

        基底節(jié)鈣化在臨床頭顱CT檢查過程中較多見,但既往多集中于研究家族性特發(fā)性基底節(jié)鈣化與甲狀旁腺功能低下等病理性基底節(jié)鈣化[1-2],而較少研究報道生理性基底節(jié)鈣化。并且,有關生理性基底節(jié)鈣化與腦血管疾病的研究報道更是少見。為此,本文通過回顧性研究,分析高尿酸、高同型半胱氨酸血癥(hyperhomocysteinemia,HHcy)對腦梗死患者基底節(jié)鈣化發(fā)生的影響。現報道如下。

        綜上所述,發(fā)生基底節(jié)鈣化的腦梗死患者可能伴有高尿酸、HHcy的臨床特征,且ALP可能參與基底節(jié)鈣化的發(fā)生。

        參考文獻

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        [2]鐘金城,楊渭川.兒童甲狀旁腺功能低下顱腦CT診斷[J].現代醫(yī)用影像學,2014,23(6):668-670.

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        [5] Hozumi I.Progress on the pathophysiology of idiopathic basal ganglia calcification[J].Brain Nerve,2019,71(1):59-66.

        [6] Levina N,Maes F,Sabbe B G C.Psychosis due to idiopathic basal ganglia calcification[J].Tijdschr Psychiatr,2019,61(1):48-52.

        [7]胡亞卓,李轉會,樊新紅,等.腦梗死患者基底節(jié)鈣化與高密度脂蛋白及頸動脈內中膜厚度的相關性研究[J].現代醫(yī)藥衛(wèi)生,2014,30(18):2813-2814.

        [8]溫慧軍.急性腦梗死病人頸動脈粥樣硬化與肌紅蛋白、尿酸的相關性分析[J].中西醫(yī)結合心腦血管病雜志,2016,14(20):2356-2358.

        [9]盧丹丹,王佩,萬莉,等.腦梗死患者尿酸、氧化應激水平與早期病情進展關系及普羅布考干預作用研究[J].臨床軍醫(yī)雜志,2017,45(1):56-59.

        [10] Du L,Ma J,Zhang X.Higher serum uric acid may contribute to cerebral infarction in patients with type 2 diabetes mellitus:a Meta-Analysis[J].J Mol Neurosci,2017,61(1):25-31.

        [11] Wang D,Hu B,Dai Y,et al.Serum uric acid is highly associated with epilepsy secondary to cerebral infarction[J].Neurotox Res,2019,35(1):63-70.

        [12] Li M,Huang Y,Lin H,et al.Association of uric acid with stenosis of intracranial and extracranial arteries in elderly patients with cerebral infarction[J].Neurol Sci,2019,40(5):957-961.

        [13] Dhanesha N,Vázquez-Rosa E,Cintrón-Pérez C J,et al.

        Treatment with uric acid reduces infarct and improves neurologic function in female mice after transient cerebral ischemia[J].J Stroke Cerebrovasc Dis,2018,27(5):1412-1416.

        [14]趙成敏.高同型半胱氨酸血癥與頸動脈內膜中層厚度的相關性分析[J].全科醫(yī)學臨床與教育,2015,13(1):100-101.

        [15] Chung Y C,Kruyer A,Yao Y,et al.Hyperhomocysteinemia exacerbates Alzheimer's disease pathology by way of the β-amyloid fibrinogen interaction[J].J Thromb Haemost,2016,14(7):1442-1452.

        [16]馬龍,凡奇,楊淼,等.急性腦梗死患者血清Hcy、UA和CRP水平變化及與頸動脈粥樣硬化的關系[J].河北醫(yī)藥,2018,40(8):1180-1183.

        [17]楊潔怡,姚麗娟,姚根新,等.心房纖顫、同型半胱氨酸、C反應蛋白與老年糖尿病患者頸動脈粥樣硬化相關性分析[J].全科醫(yī)學臨床與教育,2019,17(1):46-48.

        [18] Fu H J,Zhao L B,Xue J J,et al.Elevated serum homocysteine(Hcy) levels may contribute to the pathogenesis of cerebral infarction[J].J Mol Neurosci,2015,56(3):553-561.

        [19]董燕燕,陳光亮.高同型半胱氨酸血癥危害及致病機制研究進展[J].中國藥理學通報,2014,30(9):1205-1208.

        [20]王雅瓊,張斌.腦梗死患者血清Hcy、UA、FBG和BP與頸動脈粥樣硬化斑塊的關系[J].江蘇醫(yī)藥,2016,42(8):931-933.

        [21] Casado-Naranjo I,Romero Sevilla R,Portilla Cuenca J C,et al.Association between subclinical carotid atherosclerosis,hyperhomocysteinaemia and mild cognitive impairment[J].Acta Neurol Scand,2016,134(2):154-159.

        (收稿日期:2019-09-11) (本文編輯:董悅)

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