血浆同型半胱氨酸水平与缺血性脑卒中复发的关系  

Relationship between plasma homocysteinemia concentration and recurrence of ischemical cerebral stroke

作　　者：陆敏[1] 姜建东[1] 袁存国[1] 王军[1] 赵艳霞[1] 

机构地区：[1]南京医科大学附属南京第一医院神经内科,210006

出　　处：《临床神经病学杂志》2009年第2期142-144,共3页Journal of Clinical Neurology

摘　　要：目的探讨血浆同型半胱氨酸(Hcy)水平与缺血性脑卒中(ICS)复发的关系。方法用荧光偏振免疫法检测303例初发、97例复发ICS患者[动脉粥样硬化性血栓性脑梗死173例(血栓组)、腔隙性脑梗死170例(腔梗组)、心源性脑栓塞57例(栓塞组)]及200例非脑血管病患者(对照组)的血浆Hcy水平。对ICS复发因素进行多因素回归分析。结果(1)ICS患者血浆Hcy水平[血栓组(16.17±10.83)μmol/L、腔梗组(14.64±7.71)μmol/L、栓塞组(15.75±6.8)μmol/L]显著高于对照组[(9.61±4.22)μmol/L](均P<0.01);各类型ICS组之间血浆Hcy水平差异无统计学意义(均P>0.05);(2)ICS复发患者血浆Hcy水平[(18.04±10.68)μumol/L]显著高于初发患者[(14.57±8.50)μmol/L](P<0.01),以及高Hcy血症比率(50.5%)显著高于初发患者(32.3%)(P<0.01);(3)各类型ICS复发患者之间血浆Hcy水平差异无统计学意义(均P>0.05);(4)高Hcy血症、糖尿病是ICS复发的独立危险因素(P<0.001,P<0.05)。结论ICS复发患者的血浆Hcy水平以及高Hcy血症比率显著高于初发患者,高Hcy血症是ICS复发的独立危险因素。Objective To investigate the relationship between concentration of plasma homocysteine （Hcy） and recurrence of ischemical cerebral stroke （ ICS ）. Methods Plasma Hey concentration were measured using fluorescence polarization immunoassay （ FPLA ） in 303 primary and 97 recurrent ICS patients [ 173 cases of atheroselerotic thrombotic cerebral infarction （thrombotic group）, 170 cases of lacunar cerebral infarction （lacunar group） and 57 cases of cardiogenic embolism ] and 200 non-eerebrovascular disease patients （control group ）. Muhifactorial regression analysis was conducted on recurrent factors contributing to ICS. Results （ 1 ） Plasma Hey concentration in patients with ICS [ thrombotic group （ 16.17 ± 10.83 ） μmol/L, lacunar group （ 14.64 ± 7.71 ） μmol/L, eardiogenie embolism group （15.75 ± 6.8 ） μmol/L] were significantly higher than that in the control group [ （9.61 ± 4.22） μmol/L] （all P 〈 0.01 ）. No significantly differences of plasma Hey concentrations were observed among three ICS groups. （2） Plasma Hey concentration in the recurrent ICS patients [ （18.04 ± 10.68） μmol/L ] was significantly higher than that in the primary patients [ （ 14.57 ± 8.50） μmol/L] （ P 〈 0. 01 ）. The ratio of hyperhomocysteinemia in the recurrent patients （50.5%） was also significantly higher than that in the primary patients （32.3%） （ P 〈 0. 01 ）. （ 3 ） There was no significant difference on plasma Hey concentration in all the recurrent cases under each category of ICS. （4） Hypereysteinemia, diabetes were independent risk factors for recurrent ICS（ P 〈 0. 001 ,P 〈 0. 05 ）. Condusions Plasma Hey concentration and the ratio of hypereysteinemia in the patients with recurrent ICS are significantly higher than those in the primary patients. Hypereysteinemia is an independent risk factor for recurrent ICS.

关 键 词：缺血性脑卒中 脑梗死 同型半胱氨酸 复发 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]