脑卒中患者血清同型半胱氨酸水平变化及其与神经功能缺损程度的关系  

Changes in serum homocysteine level of patients with stroke and its relationship with the degree of neurological impairment

作　　者：汪国宏[1] 朱幼玲[1] 穆燕芳[1] 周群[1] 张留福[1] 黄治飞[1] 蔡伟[1] 

机构地区：[1]安徽医科大学第三附属医院合肥市第一人民医院,合肥230061

出　　处：《山东医药》2013年第32期22-24,共3页Shandong Medical Journal

基　　金：安徽医科大学校科学研究基金项目(2011xkj080)

摘　　要：目的观察脑卒中患者血清同型半胱氨酸(Hcy)水平变化,并分析其与神经功能缺损程度的关系。方法选择脑卒中住院患者360例,其中脑梗死260例(CI组),脑出血100例(CH组);另选同期住院非脑卒中患者200例为对照组。检测所有研究对象入院时血清Hcy、血糖(GLU)、TG、TC、HDL、LDL-C、血浆纤维蛋白原(FIB)水平,并行神经功能缺损评分;对脑卒中患者性别、年龄、GLU、TG、TC、HDL、LDL、FIB、Hcy与神经功能缺损评分进行多元线性回归分析。结果与对照组比较,CI组和CH组血清Hcy水平升高(P均<0.01)。CI组轻度神经功能缺损160例、中度75例、重度25例,CH组分别为44、40、16例。CI组、CH组中神经功能缺损程度不同者之间Hcy水平比较,差异均有统计学意义(P均<0.01)。血清Hcy水平与脑卒中患者神经功能缺损程度呈正相关(r=0.603,P<0.01)。结论脑卒中患者血清Hcy水平升高,高Hcy血症是脑卒中的独立危险因素;血清Hcy水平可反映脑卒中病情的严重程度,有助于评估预后及指导临床治疗。Objective To observe the changes in the serum homocysteine （Hcy） level of patients with stroke and its relationship with the degree of neurological impairment. Methods A total of 360 cases of patients with stroke, including 260 cases of patients with cerebral infarction （ CI group） and 100 cases of patients with cerebral hemorrhage （ CH group） were selected ; and 200 contemporary non-stroke inpatients were chosen as the control group. The levels of Hey, blood glu- cose （GLU）, TG, TC, HDL, LDL-C and FIB in the three groups were detected; the scores of neurological impairment were recorded; sex, age, GLU, TG, TC, HDL, LDL, FIB, Hey and neurological impairment scores were analyzed with multiple linear regression. Results Hcy levels of the CI group and CH group were higher than that of the control group （P 〈 0.01 ）. In terms of neurological impairment, in the CI group, mild degree, moderate degree and severe degree were re- spectively 160 cases, 75 cases and 25 cases; in the CH group, they were respectively 44 cases, 40 cases and 16 cases. According to the degrees of neurological impairment, the difference of serum Hcy levels between CI group and CH group was of statistical significance （ all P 〈0.01）. There was a positive correlation between the serum Hcy level and the degree of neurological impairment （ r = 0.603, P 〈 0.01 ）. Conclusions The level of Hcy increases in patients with stroke, and hyperhomocysteinemia is an independent risk factor for stroke; serum Hcy level may reflect the severity of stroke, which contributes to the assessment of prognosis and guiding clinical treatment.

关 键 词：脑卒中 同型半胱氨酸 血糖 血脂 神经功能缺损程度 

分 类 号：R743.3[医药卫生—神经病学与精神病学]