急性脑梗死患者血浆同型半胱氨酸水平及意义  

The Concentration of Plasma Homocysteine in the Patients with Acute Cerebral Infarction

作　　者：邓兵梅[1] 徐恩[1] 谢海峰[1] 

机构地区：[1]广州医学院第二附属医院神经科学研究所,广东广州510260

出　　处：《中国慢性病预防与控制》2004年第6期248-250,共3页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：广东省自然科学基金资助(31776)

摘　　要：目的分析血浆同型半胱氨酸(Hcy)水平与脑梗死发病和病情程度的关系。方法选择136例急性脑梗死患者和70例对照,采用荧光偏振免疫分析法测定其空腹血浆Hcy浓度。结果脑梗死组血浆Hcy高于对照组(P<0.01)。脑梗死组18.4%合并高Hcy血症(HHcy),对照组4.3%合并高Hcy血症(P<0.01)。轻、中、重型脑梗死组的血浆Hcy呈依次升高趋势(P<0.05)。15例合并HHcy的患者接受了维生素治疗,2周后,血浆Hcy水平明显下降(P<0.01),叶酸和维生素B12则显著升高(P<0.05)。结论轻-中度HHcy在脑梗死患者中是脑梗死的独立危险因素;病情越重,血浆Hcy水平越高;维生素治疗能有效降低血浆Hcy水平。Objective To analyze the relationship between plasma homocysteine and cerebral infarction. Methods Plasma homocysteine was determined by fluorescence polarization immunoassay in 136 patients with acute cerebral infarction and 70 controls. 15 patients with hyperhomocysteinemia received remedy of vitamin supplement. Multivariate regression analysis was used to determine the risk factors for cerebral infarction. Results Plasma homocysteine of patients with CI was higher than that of controls (P<0.001). The prevalence of hyperhomocysteinemia in patients with cerebral infarction and controls was 18.4% and 4.3%, respectively (χ2=7.819, P=0.005). Median contents of homocysteine for mild, moderate, and severe CI was 10.94±4.93, 14.69±6.51, 15.80±6.89 μmol/L, respectively (P<0.05). Logistic regression found plasma homocysteine was independently associated with CI (P<0.001). After two weeks treatment with vitamins supplement, the content of plasma homocysteine of that 15 patients with hyperhomocysteinemia was lowered (P<0.001), while plasma folate and vitamin B12 were increased (P<0.05). Conclusions Mild-moderate hyperhomocysteinemia was common in the patients with CI, it was an independent risk factor for CI. Plasma homocysteine was associated with the patient's condition. The level of plasma homocysteine could be lowered effectively by vitamin supplement.

关 键 词：脑梗死 同型半胱氨酸 高同型半胱氨酸血症 维生素治疗 

分 类 号：R743.33[医药卫生—神经病学与精神病学]