血清同型半胱氨酸、超敏C反应蛋白与脑梗死复发的相关性分析  

Correlation analysis between serum homocysteine, high-sensitivity C-reactive protein and recurrence of cerebral infarction

作　　者：闫俊强 冯玉凤 黄家瑞 刘安然 张育德[1] YAN Junqiang;FENG Yufeng;HUANG Jiarui;LIU Anran;ZHANG Yude(Department of Neurology, School of Clinical Medicine of He'nan University of Science and Technology, the First Affiliated Hospital of He'nan University of Science and Technology, Luoyang 471003, China;Department of Neurology, the Sixth People’s Hospital of Luoyang City in He'nan Province, Luoyang 471003, China)

机构地区：[1]河南科技大学临床医学院河南科技大学第一附属医院神经内科,河南洛阳471003 [2]河南省洛阳市第六人民医院神经内科,河南洛阳471003

出　　处：《中国现代医生》2019年第22期26-30,共5页China Modern Doctor

摘　　要：目的分析血清同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)水平与脑梗死复发的相关性,为减少脑梗死的复发寻找新的思路及方法。方法前瞻性连续纳入2017年1~10月河南科技大学第一附属医院初发急性脑梗死住院患者200例,所有患者随访1年,排除2例死亡,2例失访,共计196例患者纳入研究,按首次发作后是否复发,分为复发组及未复发组。依据复发组脑梗死病情演变情况分为进展组及非进展组,记录患者脑梗死初发时的一般资料如性别、年龄、吸烟史、嗜酒史等;临床资料如原发性高血压病、2型糖尿病、冠心病史等;实验室检查结果如hs-CRP、血糖、尿酸(UA)、低密度脂蛋白(LDL)、肌酐(CRE)、Hcy等。分析影响初发脑梗死患者脑梗死复发及进展的危险因素。结果复发组与非复发组比较,两组之间脑梗死初发时的血清Hcy、hs-CRP、LDL、UA、CRE、高血压病、糖尿病均有显著性差异(P<0.05)。将影响复发的因素代入多因素分析得出Hcy、hs-CRP、高血压、糖尿病是影响初发脑梗死复发的独立危险因素。复发组中进展组与非进展组比较,两组之间血清Hcy、hs-CRP、UA、LDL有显著性差异(P<0.05)。将影响进展的因素进行多因素分析得出Hcy、hs-CRP是影响复发脑梗死病情进展的独立危险因素。结论同型半胱氨酸和超敏C反应蛋白可能是脑梗死复发和进展的独立危险因素,降低同型半胱氨酸和hs-CRP水平可能对脑梗死复发有益。Objective To analyze the relationship between serum homocysteine(Hcy) and high-sensitivity C-reactive protein(hs-CRP) levels and recurrence of cerebral infarction, and to find new ideas and methods for reducing the recurrence of cerebral infarction. Methods 200 patients with sudden attack of acute cerebral infarction who were hospitalized in the First Affiliated Hospital of Henan University of Science and Technology from January to October 2017 were prospectively and continuously enrolled. All patients were followed up for one year, 2 deceased patients were excluded, and 2 patients were lost to follow-up.A total of 196 patients were included in the study. According to recurrence or no recurrence after the first attack, they were divided into recurrence group and non-recurrence group. According to the evolution of cerebral infarction in the recurrence group, the patients were divided into the progression group and the non-progression group. The general information such as gender, age, smoking history, and alcohol abuse history were recorded during the first attack of cerebral infarction;clinical data such as essential hypertension, type 2 diabetes, and history of coronary heart disease were recorded;laboratory findings such as hs-CRP, blood glucose, uric acid (UA), low density lipoprotein (LDL), creatinine (CRE), and Hcy were recorded. The risk factors affecting the recurrence and progression of cerebral infarction in patients with first attack of cerebral infarction were analyzed. Results There were significant differences in serum Hcy, hs-CRP, LDL, UA, CRE, hypertension and diabetes between the recurrence group and the non-recurrence group during the first attack of cerebral infarction(P<0.05). The factors affecting recurrence were substituted into multivariate analysis, showing that Hcy, hs-CRP, hypertension, and diabetes were independent risk factors for recurrence of cerebral infarction after its first attack. There were significant differences in serum Hcy, hs-CRP, UA and LDL between the progression group an

关 键 词：脑梗死复发 同型半胱氨酸 超敏C反应蛋白 

分 类 号：R743.3[医药卫生—神经病学与精神病学]