高同型半胱氨酸血症与老年急性脑梗死预后的关系研究  

Correlation between hyperhomocysteine and prognosis in elderly acute cerebral infarction patients

作　　者：王晶[1] 刘家丰[1] 郭兆慧[1] 孙杰[1] 曲延民[1] 

机构地区：[1]哈尔滨市第一医院神经内科,150010

出　　处：《中华老年心脑血管病杂志》2013年第6期599-601,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：黑龙江省卫生厅科研项目(2010-308);哈尔滨市科技创新人才基金(RC2011QN003027)

摘　　要：目的观察血浆同型半胱氨酸(homocysteine,Hcy)对老年急性脑梗死患者预后的影响。方法选择老年急性脑梗死患者377例。根据入院时血浆Hcy水平分为高Hcy血症组251例和对照组126例,观察2组患者的临床特征,神经功能及残疾评定采用美国国立卫生研究院脑卒中量表(the national institutes of health stroke scale,NIHSS)和改良Rankin量表评分,所有患者随访至90d,比较2组预后。结果与对照组比较,高Hcy血症组90d时NIHSS评分<4分、入院时及90d时改良Rankin量表评分0～2分的比例明显升高,颈动脉内膜中层厚度明显增厚,差异有统计学意义(P<0.05)。logistic回归分析显示,高Hcy血症是老年急性脑梗死预后不良的独立危险因素(OR=1.473,95%CI:0.878～3.246,P=0.039)。结论高Hcy的老年急性脑梗死患者神经功能缺损更重,预后不良。Objective To study the effect of hyperhomocysteine （Hcy） on prognosis in elderly acute cerebral infarction （ACI） patients. Methods Three hundred and seventy-seven elderly ACI pa- tients were divided into Hcy group （n=251） and control group （n= 126） according to their Hcy level at admission. Their clinical manifestations were recorded, and their neural function and disa- bility were assessed according to the NIHSS and modified Rankin scale （mRS）. The patients were followed up for 90 clays during which their prognoses were compared. Results The NIHSS and mRS scores and the carotid IMT were significantly higher in Hcy group than in control group on day 90 after admission than at admissionn （P〈0.05）. Logistic analysis showed that Hcy was an independent risk factor for the poor prognosis in elderly ACI patients （OR=1. 473,95%CI： 0. 878--3. 246,P=0. 039）. Conclusion Hcy can lead to severe neurological deficit and poor prog- nosis in elderly ACI patients.

关 键 词：超声检查 多普勒 经颅 脑梗死 高半胱氨酸 动脉粥样硬化 危险因素 预后 

分 类 号：R743.33[医药卫生—神经病学与精神病学]