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目的分析脑梗死患者血清同型半胱氨酸(Hcy)、尿酸(UA)、叶酸水平变化及其临床意义。方法选取东南大学医学院附属江阴市人民医院2014年10月—2016年12月收治的脑梗死患者150例作为脑梗死组,同期健康体检者50例作为健康对照组。比较两组及不同牛津郡社区卒中计划分型(OCSP分型)脑梗死患者血清Hcy、UA及叶酸水平;各指标间的相关性分析采用直线相关分析。结果脑梗死组患者血清Hcy、UA水平高于健康对照组,血清叶酸水平低于健康对组(P<0.05)。直线相关分析结果显示,脑梗死患者血清Hcy水平与血清UA水平呈正相关(r=0.526,P<0.05),血清Hcy水平与血清叶酸水平呈负相关(r=-0.484,P<0.05),血清UA水平与血清叶酸水平呈负相关(r=-0.541,P<0.05)。后循环梗死(POCI)型、完全前循环梗死(TACI)型脑梗死患者血清Hcy、UA水平高于腔隙性脑梗死(LACI)型、部分前循环梗死(PACI)型脑梗死患者,血清叶酸水平低于LACI型、PACI型脑梗死患者(P<0.05);TACI型脑梗死患者血清Hcy水平高于POCI型脑梗死患者,血清叶酸水平低于POCI型脑梗死患者(P<0.05)。结论脑梗死患者血清Hcy、UA水平升高,血清叶酸水平降低,检测血清Hcy、UA及叶酸水平有利于诊断脑梗死及判断其分型、病情严重程度等。
Objective To analyze the changes of serum homocysteine (Hcy), uric acid (UA), folic acid and their clinical significance in patients with cerebral infarction. Methods A total of 150 patients with cerebral infarction who were treated in Jiangyin People’s Hospital affiliated to Medical College of Southeast University from October 2014 to December 2016 were selected as the cerebral infarction group and 50 healthy subjects were selected as the healthy control group. Hcy, UA and folic acid levels in patients with cerebral infarction were compared between two groups and different Oxfordshire community-based stroke plans (OCSP). Correlation analysis was used to analyze the correlation between each index. Results Serum levels of Hcy and UA in patients with cerebral infarction were significantly higher than those in healthy controls and serum folic acid levels were lower than those in healthy controls (P <0.05). Linear correlation analysis showed that there was a positive correlation between serum Hcy level and serum UA level in patients with cerebral infarction (r = 0.526, P <0.05), serum Hcy level was negatively correlated with serum folic acid level (r = -0.484, P <0.05) UA levels were negatively correlated with serum folate levels (r = -0.541, P <0.05). The levels of serum Hcy and UA in patients with POCI type and TACI type were higher than those with LACI type and PACI type. Serum folic acid (P <0.05). The level of serum Hcy in patients with TACI cerebral infarction was higher than those in patients with POCI-type cerebral infarction and the level of serum folate was lower than those in patients with POCI-type cerebral infarction (P <0.05). Conclusions Serum levels of Hcy and UA are elevated in patients with cerebral infarction, and serum folate levels are lower. Serum Hcy, UA and folate levels are helpful for the diagnosis of cerebral infarction and their classification, severity of illness and so on.