脑梗死急性期淡漠与血浆同型半胱氨酸、糖化血红蛋白及功能障碍的相关性分析  

Correlation of apathy during the acute stage of stroke with serum homocysteine, glycated hemoglobin and functional disability

作　　者：王君[1,2] 王正则[2] 高连波[2] 田沈[2] 周环[2] 曹云鹏[1] 

机构地区：[1]中国医科大学附属第一医院神经内科, 沈阳110001 [2]中国医科大学附属第四医院神经内科,沈阳110032

出　　处：《中国医师杂志》2016年第1期38-41,46,共5页Journal of Chinese Physician

基　　金：国家自然科学基金（81371227）

摘　　要：目的 探讨脑梗死急性期淡漠与血浆同型半胱氨酸、糖化血红蛋白、功能障碍是否相关,探讨卒中后淡漠的可能相关因素.方法 病例组来自中国医科大学附属第四医院连续入院的急性脑梗死患者298例,对照组为同期具有明确脑动脉粥样硬化危险因素的本院体检者298例.脑梗死发生2周内应用淡漠量表（AS）评估卒中后淡漠,AS评分≥14分诊断为淡漠,由此将病例组分为淡漠组（A组）与非淡漠组（NA组）.应用mRS评定卒中功能障碍,应用BI评分评估日常生活能力,同时抽取患者静脉血检测血浆同型半胱氨酸（Hcy）、糖化血红蛋白A1c（HbA1c）、血脂系列、纤维蛋白原（Fib）.结果 病例组淡漠的发病率明显高于对照组（P＜0.01）.在病例组中,A组年龄、mRS评分、Hcy水平明显高于NA组（P＜0.01）,A组受教育程度、BI评分、HbA1c水平明显低于NA组（P＜0.05）.在A组中mRS评分与AS评分呈正相关（B=1.508,P=0.003）,Hcy水平与AS评分呈正相关（B =0.170,P=0.013）,HbA1c水平与AS评分呈负相关（B=-0.872,P=0.031）.结论 脑梗死急性期淡漠与糖化血红蛋白、同型半胱氨酸水平及功能障碍密切相关.Objective To investigate whether apathy during the acute stage of stroke was related to glycated hemoglobin and homocysteine（Hcy） and functional disability,and to elucidate possible factors that are related to poststroke apathy （PSA）.Methods Totally 298 patients with acute cerebral infarction who met the inclusion and exclusion criteria were recruited from the Fourth Affiliated Hospital of China Medical University.The control group of 298 volunteers was recruited from medical center in our hospital during the same period.The apathy scale （AS） was used to assess PSA within 2 weeks after stroke.Patients with an AS score≥ 14 points were defined as PSA,and the patients were divided into apathy group （A group） and non-apathy group （NA group） according to AS score.Modified Rankin Scale （mRS） was used to assess functional disability.Functional disability in daily living activities was assessed with the Barthel Index（BI）.Serum levels of Hcy,glycated hemoglobin A1C （HbA1 c）,lipid series and fibrinogen of patients were determined.Results The prevalence of PSA in patients was significantly higher than the control group （P 〈 0.01）.In the case group,A group had an older age,higher mRS score,higher Hcy level,lower educational level,lower BI score,and lower HbA1C level than the NA group（P 〈0.05）.In the A group,the mRS score was positively correlated with the AS score（B =1.508,P =0.003）,serum Hcy level was positively correlated with the AS score（B =0.170,P =0.013）,the HbA1C level was negatively correlated with the AS score（B =-0.872,P =0.031）.Conclusions The serum Hcy level,HbA1C level and functional disability are closely related to apathy during the acute stage of ischemic stroke.

关 键 词：脑梗死 情绪障碍 高半胱氨酸/代谢 血红蛋白A 糖基化/代谢 

分 类 号：R743.3[医药卫生—神经病学与精神病学]