血浆同型半胱氨酸水平与复发性脑梗死关系的临床研究  

The clinical study on relationship between plasma homocysteine levels and recurrent cerebral infarction

作　　者：范蓉[1] 辛世萌[1] 范鸿博[1] 薛俊燕[1] 

机构地区：[1]大连医科大学附属第二医院神经内科,辽宁省116027

出　　处：《中华脑血管病杂志（电子版）》2012年第3期24-28,共5页Chinese Journal of Cerebrovascular Diseases(Electronic Edition)

摘　　要：探讨复发性脑梗死与血浆Hcy水平的关系。方法 100例急性脑梗死患者作为研究对象,50例非急性脑梗死患者作为对照组。将研究对象分为不同临床亚组、各类型急性脑梗死组、初发组与复发组,比较各组患者血浆Hcy水平及高Hcy比率。同时监测血压、血糖和血脂,对脑梗死的复发进行多因素分析。结果 (1)脑梗死复发患者血浆Hcy水平高于初发患者(P<0.01),且复发组高Hcy比率(54.45%)高于初发组(32.83%)(P<0.05)。(2)各类型急性脑梗死患者血浆Hcy水平均高于非急性脑梗死患者(P<0.01);各类型脑梗死患者之间血浆Hcy水平无显著性差异(P>0.05)。(3)1年内和1年后脑梗死复发患者血浆Hcy水平无显著性差异(P>0.05)。(4)各类型脑梗死复发患者之间血浆Hcy水平差异无显著性(P>0.05);血栓形成性脑梗死复发患者高Hcy比率略高于其他类型脑梗死(P>0.05)。(5)多因素分析显示脑梗死复发与高Hcy水平密切相关(P<0.01)。结论高血浆Hcy水平是脑梗死复发的独立危险因素。Objective To discuss the relationship between the recurrent cerebral infarction and plasma homocysteine. Metuods 100 patients hospitalized with acute cerebral infarction patients were selected as research subjects, and the other 50 patients with non-hospitalized patients without acute cerebral infarction were selected as a control group. 100 patients were divided into different clinical subgroups-all types of acute cerebral infarction, the initial onset and relapse group, high plasma Hcy levels and Hcy ratio were compared among groups. At the same time routinely checked blood pressure, blood glucose andblood lipids, and also did a multivariate analysis of recurrence cerebral infarction. Results （1）Plasma Hcy levels in patients with recurrent cerebral infarction were higher than first onset patients （ P 〈 0.01 ） ; and the relapse rate of homocysteine group （54.45%） were also higher than onset group （32.83%）, the difference was statistically significant （ P 〈 0.05 ）. （ 2 ） Various types of plasma Hcy in patients with acute cerebral infarction was higher than non-acute cerebral infarction, the difference was statistically significant （P 〈 0.01 ） ; various types of plasma Hcy levels between patients with cerebral infarction was no significant difference （P 〉 0.05 ）. （3）One year and one year after the plasma Hcy levels in patients with recurrent cerebral infarction was no significant difference （ P 〉 0.05 ）. （ 4 ） Among various types of plasma Hcy in patients with recurrent cerebral infarction was no significant difference （P 〉 0.05 ） ; recurrent thrombosis in patients with cerebral infarction rate slightly higher than the other types of high Hcy infarction （ P 〉 0.05 ）.（5） Multivariate analysis showed that cerebral infarction recurrence is closely related to high Hcy levels and diabetes （P 〈 0. 01, P 〈 0. 05）. Conclusions High plasma Hcy levels are independent risk factor for recurrence of cerebral infarction.

关 键 词：脑梗死 复发 同型半胱氨酸 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]