不同程度缺血性脑卒中患者血浆同型半胱氨酸水平及临床意义  

Plasma Homocysteine Levels in Patients with Different Degrees of Ischemic Stroke and the Clinical Significance

作　　者：王家悦[1] 王革生[2] 

机构地区：[1]北京中医药大学,北京100078 [2]北京中医药大学东方医院脑三科,北京100078

出　　处：《血栓与止血学》2017年第6期936-938,共3页Chinese Journal of Thrombosis and Hemostasis

摘　　要：目的探讨不同程度缺血性脑卒中(IS)患者血浆同型半胱氨酸(Hcy)水平及临床意义。方法以我院2012年2月至2015年8月收治的90例IS患者(记为IS组)及同期于我院体检的60例健康志愿者(记为健康组)为对象,比较2组血浆Hcy水平、凝血功能[活化部分凝血活酶时间(a PTT)、血浆凝血酶时间(TT)、纤维蛋白原(Fbg)],并探讨不同程度IS以美国国立卫生研究院卒中量表(NIHSS分级)评估与血浆Hcy水平关系以及血浆Hcy水平在疾病预后中影响。结果 IS组血浆Hcy水平、Fbg较健康组明显高,a PTT、TT明显低,差异有统计学意义(P<0.05);重度IS患者血浆Hcy水平最高,中度次之,轻度最低,三者之间两两相较,差异有统计学意义(P<0.05);Hcy升高患者的血管事件的总发生率31.82%明显高于Hcy正常患者10.87%(P<0.05)。结论血浆Hcy水平是IS疾病发生及预后的影响因素,不同程度IS与血浆Hcy水平呈正相关。Objective To investigate the plasma homocysteine （Hcy）levels in patients with different degrees of ischemic stroke （IS） and the clinical significance. Methods From February 2012 to August 2015, 90 patients with IS（ IS group）and 60 healthy volunteers（ healthy group）receiving physical examination during the same period in our hospital were enrolled in the study. The plasma Hey levels and coagulation function [ activated partial thromboplastin time（ aPTT）, thrombin time （TT） , fibrinogen（Fbg） ] were compared between the two groups. The correlation between different degrees of IS evaluated by the National Institutes of Health Stroke Scale （ NIHSS grade） and plasma Hcy levels was explored, and the effect of plasma Hcy levels on the prognosis was analyzed. Results The plasma Hcy and Fbg levels in the stroke group were significantly higher than those in the healthy group, while TT and aPTT were significantly lower （P 〈 0.05 ）. The plasma Hcy levels in patients with severe stroke were the highest, followed by moderate stroke times and mild stroke （P 〈 0.05 ）. The total incidence of vascular events in patients with increased Hcy was significantly higher than that in patients with normal Hcy （31.82% vs 10. 87% ） （ P 〈 0. 05 ）. Conclusion Plasma Hcy level is the influencing factor of IS and prognosis. Different degree of IS and plasma Hcy level are positively correlated.

关 键 词：缺血性脑卒中 同型半胱氨酸 

分 类 号：R743[医药卫生—神经病学与精神病学]