Objective To explore the gender differences in the degree of leukoaraiosis and serum uric acid, homocysteine (Hcy), blood lipid levels in the elderly patients, and to provide reference for the prevention and treatment of leukoaraiosis. Method Collected the clinical data of 109 cases of elderly patients ( ≥ 80 years old) who admitted in our hospital from June 2013 to May 2015. Differences in brain CT images were compared between genders and blood uric acid, homocysteine, triglyceride, total cholesterol, apolipoprotein A (ApoA), apolipoprotein B (Apo B), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), lipoprotein alpha levels. Result The detection rate of white matter changes in male patients was higher than that in female patients (P < 0.05). Gender differences in detection rate in brain atrophy, bilateral basal ganglia lacunar infarction, bilateral coronal region radiation lacunar infarction, brain stem infarction, cerebellar infarction, frontal lobe infarction, thalamus infarction, parietal lobe infarction, occipital lobe infarction, temporal lobe infarction and infarction of corpus callosum had no obvious differences (P > 0.25). There were no significant differences in the proportion of sex-specific patients with CT classification (P > 0.05). There were no significant differences in serum uric acid, blood Hcy and blood lipid levels between patients with CT grade 2 and CT grade 3 (P > 0.05). The levels of serum uric acid and homocysteine were higher in male patients than in female patients (P<0.05), and the levels of total cholesterol and apolipoprotein A of men were lower than that of women (P < 0.05). Hcy level was the risk factor for the occurrence of leukoaraiosis screened by two Logistic stepwise regression analysis, and the relative risk was 1.12 (P < 0.05). Conclusion In the elderly cases, leukoaraiosis is more common in male, with higher blood uric acid, homocysteine levels, however, no obvious correlation is found with dyslipidemia. Severe leukoaraiosis is the most commonest type in elderly people, and the serum uric acid, homocysteine, blood lipid levels are not significantly correlated with CT classification of leukoaraiosis. High level homocysteine is a risk factor of leukoaraiosis in elderly people.%目的：探讨高龄患者脑白质疏松程度及血尿酸、同型半胱氨酸（homocysteine，Hcy）、血脂水平的性别差异，为脑白质疏松的防治提供参考依据。方法收集2013年6月至2015年5月于本院住院的109例年龄≥80岁患者的临床资料。比较不同性别患者的头颅 CT 检查结果及血尿酸、Hcy、甘油三酯（TG）、总胆固醇（TC）、载脂蛋白 A（Apo A）、载脂蛋白 B（Apo B）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、脂蛋白（α）等水平的差异。结果男性患者脑白质疏松检出率高于女性患者（P ＜0.05）。而不同性别患者的脑萎缩、双侧基底节腔隙性脑梗死、双侧辐射冠区腔隙性脑梗死、脑干梗死、小脑梗死、额叶梗死、丘脑梗死、顶叶梗死、枕叶梗死、颞叶梗死及胼胝体梗死检出率比较差异均无显著性（P ＞0.05）。不同性别患者脑白质疏松 CT 分级所占比例比较均无显著差异（P ＞0.05）。脑白质疏松 CT 分级2级和3级患者的血尿酸、Hcy 及血脂水平比较差异均无显著性（P ＞0.05）。男性患者血尿酸和 Hcy 水平均高于女性患者（P ＜0.05），TC 和 Apo A 水平均低于女性患者（P ＜0.05）。采用二分类 Logistic 逐步回归分析筛选脑白质疏松发生的危险因素仅为Hcy 水平，其相对危险度为1.12（P ＜0.05）。结论在高龄人群中，以男性脑白质疏松更多见，与其血尿酸、Hcy 水平升高相关，而与血脂异常无明显相关性。高龄人群以重度脑白质疏松为主，其血尿酸、Hcy、血脂水平与脑白质疏松CT分级无明显相关性。高Hcy水平是高龄人群发生脑白质疏松的危险因素。
展开▼
