Risk factors of cerebral infarction in elderly patients with hypertension and predictive value of lipoprotein a, Hcy and D-dimer
10.3760/cma.j.cn101721-20241009-00320
- VernacularTitle:老年高血压患者发生脑梗死的危险因素及脂蛋白a、Hcy、D二聚体的预测价值
- Author:
Ting WANG
1
;
Yan ZHANG
1
Author Information
1. 陕西省榆林市第一医院神经内科，榆林 719000
- Publication Type:Journal Article
- Keywords:
Hypertension;
Cerebral infarction;
D-dimer;
Homocysteine;
Lipoprotein a;
Old people
- From:
Clinical Medicine of China
2025;41(3):170-174
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the risk factors of cerebral infarction in elderly patients with hypertension and the predictive value of lipoprotein a, homocysteine (Hcy) and D-dimer.Methods:A retrospective case-control study was conducted for this study. The clinical data of 234 elderly patients with hypertension in the First Hospital of Yulin were collected from January 2023 to March 2024, including 124 cases with cerebral infarction (observation group) and 110 cases without cerebral infarction (control group).Normally distributed quantitative data were expressed as xˉ?±s, two independent sample t test was used on comparison between groups. Skew distributed quantitative data were expressed as M( Q 1, Q 3), rank-sum test was used on comparison between groups. Counting data were expressed as n(%), chi-square test was used on comparison between groups. Risk factors of cerebral infarction in elderly hypertensive patients were explored by multivariate Logistic regression analysis. Receiver operating characteristic curve (ROC) was drawn to analyze the predictive value of lipoprotein a, Hcy and D-dimer on cerebral infarction in hypertensive patients. Results:The proportions of males and alcohol drinking [54.8%(68/124) vs. 40.0% (44/110), 21.8%(27/124) vs. 11.8% (13/110), χ2=5.14, P=0.023, χ2=4.08, P=0.043], systolic blood pressure [(160±13) mmHg (1 mmHg=0.133 kPa) vs. (149±13) mmHg, t=6.53, P<0.001] and levels of serum lipoprotein a, Hcy and D-dimer [234.4 (122.6, 491.8) mg/L vs. 137.3 (63.0, 230.0) mg/L, 18.6 (16.0, 23.2) μmol/L vs. 14.4 (11.9, 17.6) μmol/L, 0.62 (0.39, 1.18) mg/L vs. 0.33 (0.25, 0.54) mg/L, Z=4.20, 6.96, 5.82, all P<0.001] were higher in the observation group compared to the control group, and the age was older than that in the control group [72.0 (66.2, 78.0) years old vs. 68.0 (65.0, 73.2) years old, Z=3.08, P=0.002]. Multivariate Logistic regression analysis suggested that after excluding the influence of other factors, systolic blood pressure ( OR=1.06, 95% CI: 1.03-1.09, P<0.001), alcohol drinking ( OR=6.02, 95% CI: 1.88-19.29, P=0.003), lipoprotein a ( OR=1.00, 95% CI: 1.00-1.01, P<0.001), Hcy ( OR=1.22, 95% CI: 1.13-1.31, P<0.001) and D-dimer ( OR=1.96, 95% CI: 1.22-3.14, P=0.005) were risk factors for cerebral infarction in elderly patients with hypertension. The area under ROC curve(AUC) of combination of serum lipoprotein a, Hcy and D-dimer in predicting CI was greater than that of single detection (0.85 vs. 0.66, 0.76, 0.72, all P<0.001). Conclusions:Systolic blood pressure, alcohol drinking, lipoprotein a, Hcy, D-dimer are risk factors for cerebral infarction in elderly hypertensive patients. Serum lipoprotein a, Hcy and D-dimer have high diagnostic value on cerebral infarction, and combined detection has the highest diagnostic efficiency.
