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目的 :探讨高同型半胱氨酸血症(HHCY)与缺血性脑血管病(ICVD)的相关性。方法 :选取2011年9月~2015年12月我院神经内科收治的130例脑梗死(CI)患者、67例短暂性脑缺血发作(TIA)患者以及同期我院体检科确诊的90例非ICVD患者(对照组)作为研究对象,采用循环酶法检测所有研究对象的血清同型半胱氨酸(HCY),分析血清HCY水平与ICVD病变类型、病情严重度的相关性。结果 :1三组研究对象血清HCY水平相比差异有统计学意义,对照组血清HCY水平显著低于CI组与TIA组,CI组与TIA组之间血清HCY水平相比差异无统计学意义。2 ICVD患者血清HCY水平与其美国国立卫生院神经功能缺损量表(NIHSS)评分之间无相关性。3三组研究对象高甘油三酯血症、高胆固醇血症、糖尿病、高血压等危险因素百分率相比差异有统计学意义,对照组上述危险因素百分率均显著低于CI组与TIA组,CI组与TIA组上述危险因素百分率相比差异无统计学意义。4采用多因素Logistic回归分析ICVD发生的危险因素,HHCY、高甘油三酯血症、高血压等3个指标具有统计学意义,高胆固醇血症、糖尿病等2个指标无统计学意义。结论 :HHCY是ICVD发生的独立危险因素,但HHCY与ICVD病变类型、病情严重度无相关性。
Objective: To investigate the relationship between hyperhomocysteinemia (HHCY) and ischemic cerebrovascular disease (ICVD). Methods: From September 2011 to December 2015, 130 patients with cerebral infarction (CI), 67 patients with transient ischemic attack (TIA) and 90 patients diagnosed in our hospital during the same period were enrolled in our department of neurology. Patients with ICVD (control group) were enrolled in this study. Serum homocysteine (HCY) was detected by enzymatic cycling in all subjects. The correlation between serum HCY level and ICVD type and severity was analyzed. Results: The serum HCY levels were significantly different among the three study groups. The serum HCY levels in the control group were significantly lower than those in the CI group and the TIA group. There was no significant difference in serum HCY levels between the CI group and the TIA group. 2 ICVD patients with serum HCY levels and the United States National Institutes of Health neurological deficit scale (NIHSS) score was not related. 3 The percentage of risk factors such as hypertriglyceridemia, hypercholesterolemia, diabetes mellitus and hypertension in the three groups was significantly different from that in the CI group and the TIA group There was no significant difference in the percentage of risk factors among the above groups in TIA group. The multivariate Logistic regression analysis of risk factors for ICVD, HHCY, hypertriglyceridemia, hypertension and other three indicators was statistically significant, hypercholesterolemia, diabetes and other two indicators was not statistically significant. Conclusion: HHCY is an independent risk factor for ICVD. However, there is no correlation between HHCY and the type of ICVD and the severity of ICVD.