小动脉闭塞性卒中患者血清叶酸水平与其功能预后的相关性研究  

Correlation between serum folate level and the functional outcomes of small vessel disease in ischaemic stroke patients

作　　者：刘伟[1] 史冬梅[1] 冯浩[1] 刘磊[1] 冯研[1] 于逢春[1] Liu Wei;Shi Dongmei;Feng Hao;Liu Lei;Feng Yan;Yu Fengchun(Department of Neurology,Beijing Haidian Hospital(The Haidian Section of Peking University Third Hospital),Beijing 100080,China)

机构地区：[1]北京市海淀医院(北京大学第三医院海淀院区)神经内科,100080

出　　处：《神经疾病与精神卫生》2020年第2期97-100,共4页Journal of Neuroscience and Mental Health

摘　　要：目的讨论血清叶酸水平与小动脉闭塞性卒中患者发病3个月功能预后的关系。方法回顾性分析2018年1月1日至9月30日北京市海淀医院神经内科连续收治住院符合标准的83例小动脉闭塞性卒中患者的一般及临床资料,包括年龄、性别、脑血管危险因素、入院美国国立卫生研究院卒中量表(NIHSS)评分、住院期间合并症、住院期间抗栓药物治疗等。根据发病3个月后改良Rankin量表(mRS)评分,将患者分为预后良好组(51例,mRS评分<3分)和预后不良组(32例,mRS评分≥3分),比较两组间患者的一般临床资料和血清叶酸水平的差异。所有患者入院次日晨起采集空腹静脉血,检测血清叶酸水平。采用Binary Logistic回归分析影响患者功能预后不良的独立影响因素。结果预后不良组患者的入院NIHSS评分[4.0(3.0,6.0)分]明显高于预后良好组[3.0(2.0,4.0)分;Z=-2.951,P=0.003],预后不良组患者的血清叶酸水平[11.3(9.9,16.7)μg/L]明显低于预后良好组[15.6(11.5,22.8)μg/L;Z=2.732,P=0.006]。Binary Logistic回归分析结果显示,入院NIHSS评分升高是功能预后不良的独立危险因素(OR=1.525,95%CI:1.043~2.231,P=0.030),基线血清叶酸水平升高是功能性预后不良的独立保护因素(OR=0.729,95%CI:0.554~0.960,P=0.024)。结论基线血清叶酸水平升高是功能性预后不良的独立保护因素。Objective To explore the correlation between the serum folate level and the 3-month functional outcomes of small vessel disease in ischemic stroke patients.Methods A total of 83 ischemic stroke patients classified in small vessel disease admitted in the Department of Neurology of Haidian Hospital consecutively from 1st January to 30th September 2018,were enrolled.The clinical data,including age,gender,cerebrovascular risk factors,National Institute of Health stroke scale(NIHSS)score,complications during hospitalization and antithrombotic therapy during hospitalization were analyzed.According to the modified Rankin Scale(mRS),the patients were divided into the group with good prognosis(mRS≥3)(51 cases)and the group with poor prognosis(mRS<3)(32 cases).The differences of the clinical data and serum folate concentrations were compared between the two groups.The fasting venous blood was collected to measure the serum folate level.Binary logistic regression was used to estimate the independentriskfactorsfor poor prognosis.Results The NIHSS scores of patients in poor prognosis group[4.0(3.0,6.0)]were significantly higher than those in good prognosis group[3.0(2.0,4.0)](Z=-2.951,P=0.003).The serum levels of folate in poor prognosis group[11.3(9.9,16.7)μg/L]were lower than those in good prognosis group[15.6(11.5,22.8)μg/L](Z=2.732,P=0.006).Binary logistic analysis showed that increased NIHSS wastheindependentriskfactor for poorprognosis(OR=1.525,95%CI=1.043-2.231,P=0.030),while elevated serumfolateconcentration was an independent influence factor for goodprognosis(OR=0.729,95%CI=0.554-0.960,P=0.024).Conclusions Elevated serum folate level is an independent protective factor for poor functional prognosis.

关 键 词：卒中 小动脉闭塞性 血清叶酸 功能预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]