高同型半胱氨酸血症与缺血性脑血管病危险因素的关系及干预治疗  

Relationship between hyperhomocysteinemia and risk factor of ischemic cerebrovascular diseases and intervention therapy

作　　者：庾建英[1] 杨雪荣[1] 刘继新[1] 李春丽[1] 王志丹[1] 依斯哈尔[1] 迪里夏提[1] 李文娟[1] 

机构地区：[1]新疆维吾尔自治区人民医院北院脑科中心,新疆乌鲁木齐830054

出　　处：《安徽医药》2014年第8期1483-1485,共3页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨高同型半胱氨酸血症（HHcy）与缺血性脑血管病危险因素的关系及干预治疗。方法选择265例急性缺血性脑血管病患者（其中腔隙性脑梗死85例,短暂性脑缺血发作53例,急性脑梗死127例）和140例对照,检测所有受试者空腹血浆同型半胱氨酸（Hcy）水平并与其它缺血性脑血管病危险因素进行比较。分析HHcy伴有传统危险因素时对缺血性脑血管病的影响,并进一步提出干预治疗措施及预后。结果 HHcy合并高血压病、糖尿病危险因素者可促使缺血性脑血管病的发生（P〈0.01）。使用单一维生素治疗6周无效（P〉0.05）,联合使用两种维生素治疗4-6周起效（P〈0.05）,但尚未达标,联合使用三种维生素治疗2周开始起效（P〈0.05）,4-6周达标,且随访观察1.5年,三种维生素治疗组再发缺血性脑血管病明显减少。结论 HHcy可能与缺血性脑血管病其它危险因素如高血压、糖尿病相互作用促进缺血性脑血管病的发生有关。三种维生素干预治疗4-6周,效果及预后明显优于未服维生素治疗组、一种或两种维生素治疗组。Objective To study the relationship between hyperhomocysteinemia（ HHcy） and risk factors of ischemic cerebrovascular diseases and intervention therapy. Methods Two hundred and sixty-five patients with acute ischemic cerebrovascular diseases（85 patients with lacunar infarction,53 patients with transient ischemic attack,127 patients with acute cerebral infarction） and 140 control cases were chosen. Plasm homocysteine（Hcy） levels with empty stomach were examined in all subjects and compared with other risk factors of ischemic cerebrovascular diseases. The effect of HHcy accompanied by conventional risk factors on ischemic cerebrovascular diseases was analyzed. Intervention therapy and prognosis were introduced. Results HHcy accompanied by hypertensive disease or diabetes increased the occurrence of ischemic cerebrovascular diseases（P〈0. 01）. Single vitamin therapy for 6 weeks was inefficient（P〈0. 05）. Allied two vitamin therapy for 4 to 6 weeks was effective（P〈0. 05）,but wasn＇t up to standard. Allied three vitamin therapy for 2 weeks was effective（P〈0. 05）,and was up to standard after 4 to 6 weeks. The patients of allied three vitamin therapy decreased the recurrence of ischemic cerebrovascular diseases after a follow-up of 1. 5 years. Conclusions HHcy can interact with risk factors of ischemic cerebrovascular diseases such as hypertensive disease or diabetes and promote the development of ischemic cerebrovascular diseases. The effect of intervention therapy with three vitamins is prominent compared with no vitamin therapy,single vitamin therapy and two vitamin therapy.

关 键 词：同型半胱氨酸 高同型半胱氨酸血症 缺血性脑血管病 危险因素 干预治疗 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R589[医药卫生—临床医学]