血同型半胱氨酸水平与缺血性脑卒中严重程度的关系  

Relationship between homocysteine levels in blood and severity of ischemic stroke

作　　者：宋春霞[1] 李亚军[1] 张世俊[1] 张蓓[1] 叶芸[1] 

机构地区：[1]西安医学院附属医院神经内科,陕西西安710077

出　　处：《中风与神经疾病杂志》2011年第6期547-548,共2页Journal of Apoplexy and Nervous Diseases

基　　金：西安医学院重点学科建设专项资金资助项目(No.2009-02)

摘　　要：目的分析血浆同型半胱氨酸水平与缺血性脑卒中神经功能缺损严重程度的关系。方法选择我科自2006年3月-2010年12月住院治疗的缺血性脑卒中患者1258例,于入院后次晨测定血浆同型半胱氨酸（HCy）,同时采用改良Rankin评分（mRS）对患者入院时神经功能缺损程度进行评分。将患者分为轻症组（mRS≤3分）、重症组（mRS〉3分）,以血浆同型半胱氨酸〉15μmol/L为高同型半胱氨酸血症（HHGy）,比较两组间同型半胱氨酸水平差异及高同型半胱氨酸患者比例,并分析神经功能缺损程度的相关因素。结果轻度神经功能缺损组共847例,平均mRS为1.73分;重度神经功能缺损组共411例,平均mRS为4.18分。轻症组同型半胱氨酸水平（17.7±3.9）μmol/L;重症组同型半胱氨酸水平（37.9±4.4）μmol/L。两组间高同型半胱氨酸血症患者的比例分别为9.4%和30.1%,两组比较均有统计学差异（P〈0.01）,神经功能缺损程度与同型半胱氨酸水平呈正相关（r=0.041,P〈0.01）。结论血浆同型半胱氨酸水平与缺血性脑卒中的神经功能缺损程度相关。高同型半胱氨酸血症是缺血性脑卒中的独立危险因素,也是对卒中后神经功能缺损程度预后的预测指标之一。治疗高同型半胱氨酸血症既可预防脑卒中,又对改善卒中预后起到重要的作用。Objective To analyze the relationship between plasma homocysteine（Hcy） level and loss of neurology function following cerebral arterial thrombosis.Methods 1258 patients after cerebral arterial thrombosis come from neurology department.Plasma Hcy,which density15μmol/L was defined as the elevated plasma Hcy level,of all had been detected the next morning,and disability neurology functional were scored by mRS.Then the patients group into 2 group,the light（mRS≤3） and the severe group（mRS3）.We compared the Hcy level and computed the proportion of the elevated plasma Hcy level in the two groups.Related factors of neurology functional impairment are analyzed at last.Results 847 patients are in the light cases,whose average mRS score was 1.73,and the Hcy level was（17.7±3.9）μmol/L.411 patients are in the severe cases,whose results were 4.18,（37.9±4.4）μmol/L.The percentages of the elevated plasma Hcy level are 9.4% and 30.1% differently in the two groups,which showed significantly different.Thus we investigated that the degreed of neurology functional impairment was positive correlation with the Hcy level（r=0.041,P0.01）.Conclusions Our finding suggested that the degreed of disability neurology functional was related with elevated plasma Hcy level,indicating that elevated plasma Hcy level was the risk factor independently associated the stroke and one of the predicted indexes of neurology functional impairment after apoplexy.So therapeutics of elevated plasma Hcy levels could be prevented acute cerebral accident and have effect to the stroke.

关 键 词：同型半胱氨酸 缺血性脑卒中 神经功能缺损 

分 类 号：R743.3[医药卫生—神经病学与精神病学]