脑梗死患者血浆同型半胱氨酸水平与神经缺损程度和预后转归的相关性分析

目的 观察脑梗死患者的血浆同型半胱氨酸(Homocysteine,Hcy)水平，探讨Hcy水平与脑梗死发病和预后的关系，为脑梗死的早期监测和治疗提供参考。 方法 选择2013年1月—2014年1月在温岭市第一人民医院治疗的92例脑梗死患者为研究对象，选择80例健康志愿者为对照组，比较2组患者的空腹血浆Hcy水平。对92例脑梗死患者依据临床神经功能的缺损程度评分标准进行评分，并比较不同缺损程度患者的血浆Hcy水平和短期内的死亡、伤残情况。 结果 试验组患者的平均血浆Hcy为(18.13±4.51)μmol/L，明显高于对照组的(9.24±2.88)μmol/L (χ2=15.712，P=0.017)，差异具有统计学意义；试验组患者神经缺损程度为轻型、中型和重型组的血浆Hcy分别为(15.83±2.51)μmol/L、(18.99±4.24)μmol/L和(13.13±3.98)μmol/L，组间差异不具有统计学意义(P＞0.05)；试验组患者随访1年，暂无结局患者的血浆Hcy水平为(16.31±1.54)μmol/L，致残或死亡患者的平均血浆Hcy水平为(20.43±3.01)μmol/L，差异有统计学意义(χ2=22.571，P=0.008)。 结论 脑梗死患者的血浆同型半胱氨酸水平明显升高，与神经缺损程度相关，是脑梗死患者病程监测、预后判断的灵敏指标。 

Correlation between plasma homocysteine level and neurological deficit and prognosis of cerebral infarction patients

Objective To observe the plasma homocysteine(Hcy) level of patients with cerebral infarction in order to investigate the relationship between homocysteine(Hcy) level and the incidence and prognosis of cerebral infarction,and provide the reference for the early monitoring and treatment of cerebral infarction. Methods Ninety-two cases of cerebral infarction patients were selected as the experiment group who were treated in the Civil Aviation General Hospital from January,2013 to January,2014,and 80 healthy volunteers were selected as the control group.There was no significant difference in the age and sex between the two groups.The plasma homocysteine(Hcy) levels of the two groups were compared.The patients in the experiment group were scored according to the degree of defect of the clinical neurological function.The plasma Hcy levels and prognosis of different defect degree were compared. Results The average plasma Hcy of the experimental group was (18.13±4.51) μmol/L,significantly higher than that of the control group(9.24±2.88) μmol/L(χ2=15.712,P=0.017),and the difference was statistically significant.The plasma Hcy in the experiment group of patients with nerve defect degree of slight group,moderate group and severe group was respectively (15.83±2.51) μmol/L,(18.99±4.24) μmol/L and (13.13±3.98) μmol/L,P>0.05,and the differences between different groups were not statistically significant.Patients in the experimental group were followed up for 1 years,and the level of plasma Hcy in the no outcome patients with as (16.31±1.54) μmol/L,but the average plasma Hcy of disability or death patients was (20.43±3.01) μmol/L,and the difference was statistical significance(χ2=22.571,P=0.008). Conclusion The plasma homocysteine level in patients with cerebral infarction can significantly increase and be related to the degree of neurological deficit,which is sensitive indexes of cerebral infarction patients in the course of disease monitoring and prognosis.