同型半胱氨酸、糖化血红蛋白与急性缺血性脑卒中神经功能及远期预后的相关性研究  

The Correlation between Homocysteine,Glycosylated Hemoglobin and Neural Function/Long-term Prognosis in Patients with Acute Ischemic Stroke

作　　者：王斌[1] 

机构地区：[1]南充市第二人民医院检验科,四川南充637000

出　　处：《医学综述》2016年第22期4500-4503,共4页Medical Recapitulate

摘　　要：目的探讨同型半胱氨酸（Hcy）、糖化血红蛋白（Hb A1c）与急性缺血性脑卒中神经功能及远期预后的相关性。方法选择2012年8月至2015年3月南充市第二人民医院收治的急性缺血性脑卒中患者98例,按照神经功能缺损评分（NIHSS）分为轻度组（NIHSS≤3分）27例、中度组（NIHSS4~15分）39例和重度组（NIHSS〉15分）32例,患者进行1年随访,采用改良Rankin量表（mRS）评价患者远期预后;检测各组患者Hcy、Hb A1c水平。结果中度组、重度组Hcy、Hb A1c水平均显著高于轻度组[（19.2±2.1）μmol/L、（35.4±4.8）μmol/L比（15.3±1.6）μmol/L,（6.4±0.7）%、（8.1±0.9）%比（5.8±0.5）%],其中重度组Hcy、Hb A1c水平显著高于中度组,差异有统计学意义（P〈0.05）。98例急性缺血性脑卒中患者按照mRS量表分级将预后分为预后良好组（mRS 0~2分）53例和预后不佳组（mRS 3~5分）45例;其中预后不佳组Hcy、Hb A1c水平显著高于预后良好组[（26.9±4.7）μmol/L比（20.5±3.5）μmol/L,（7.4±1.1）%比（6.3±0.9）%],差异有统计学意义（P〈0.01）。相关性分析显示,急性缺血性脑卒中患者Hcy、Hb A1c与NIHSS评分呈正相关（r=0.475,0.573,P〈0.05）;Hcy、Hb A1c亦与mRS评分呈正相关（r=0.836,0.496,P〈0.05）。结论急性缺血性脑卒中患者Hcy、Hb A1c与神经功能和远期预后呈正相关,Hcy、Hb A1c均亦可作为预测患者预后的指标之一。Objective To explore the correlation between homocysteine（ Hcy）,glycosylated hemoglobin（ Hb A1c） and neural function,long-term prognosis in patients with acute ischemic stroke. Methods A total of 98 acute ischemic stroke patients in Nanchong Second People＇s Hospital from Aug. 2012 to Mar. 2015 were selected as research objects,according to National Institutes of Health Stroke Scale（ NIHSS） score they were divided into a mild group（ NIHSS≤3） of 27 cases,a moderate group（ NIHSS 4-15） of 39 cases and a severe group（ NIHSS 15） of 32 cases. All patients were followed up for 1 year,and the mRS scale was adopted to evaluate the prognosis of the patients; the plasma Hcy,Hb A1 clevels were dectected. Results The levels of Hcy and Hb A1 cin the moderate and severe group were significantly higher than the mild group,and the levels of Hcy and Hb A1 cin the severe group were significantly higher than the moderate group [（ 19. 2 ±2. 1） μmol / L,（ 35. 4 ± 4. 8） μmol / L vs（ 15. 3 ± 1. 6） μmol / L,（ 6. 4 ± 0. 7） %,（ 8. 1 ± 0. 9） % vs（ 5. 8 ± 0. 5） % ],the differences were statistically significant（ P〈0. 05）. 98 patients with acute ischemic stroke were divided into 53 patients with good prognosis（ mRS 0-2） and 45 patients with poor prognosis（ mRS3-5）,and the level of Hcy and Hb A1 cin the poor prognosis group were significantly higher than the good prognosis group[（ 26. 9 ± 4. 7） μmol / L vs（ 20. 5 ± 3. 5） μmol / L,（ 7. 4 ± 1. 1） % vs（ 6. 3 ± 0. 9） % ],the differences were statistically significant（ P〈0. 01）. Hcy and Hb A1 cwas positively correlated with NIHSS score（ r = 0. 475,0. 573,P〈0. 05）; Hcy and Hb A1 cwas also positively correlated with mRS score（ r =0. 836,0. 496,P〈0. 05）. Conclusion The neurological function and long-term prognosis in patients with acute ischemic stroke are positively correlated with Hcy and Hb A1 c,Hcy and Hb A1 ccan be used as predictors for the prognosis.

关 键 词：急性缺血性脑卒中 同型半胱氨酸 糖化血红蛋白 神经功能 预后 

分 类 号：R743.31[医药卫生—神经病学与精神病学]