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目的探讨同型半胱氨酸(Hcy)血清水平在诊断脑梗死及评定脑梗死严重程度中的价值,探讨Hcy变化的可能机制。方法选择轻度、中度和重度脑梗死患者各40例为观察组,选择同期体检证实为健康者40例为对照组。采用电化学发光法检测血清Hcy,比较观察组与对照组胱硫醚-β合成酶(CBS)基因型和等位基因频率分布及CBS不同基因型血清Hcy水平。结果轻度脑梗死、中度脑梗死、重度脑梗死患者的血清Hcy、叶酸、维生素B12、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、基质金属蛋白酶-9(MMP-9)、神经生长因子(NGF)、神经营养因子(NTF)各项指标两两比较(P均<0.05)及分别与对照组比较(P均<0.01)差异均有统计学意义。观察组与对照组CBS基因型和等位基因频率分布有明显差异(P<0.01,P<0.05)。观察组与对照组CBS基因型正常基因型(T/T)血清Hcy差异不具有统计学意义(P>0.05),突变纯合子基因型(C/C)与杂合子基因型(C/T)血清Hcy水平存在较大差异(P<0.05,P<0.01)。结论 Hcy血清水平可以作为脑梗死的一个诊断指标,在判定脑梗死严重程度中具有很高的价值。CBS基因突变可能与血清Hcy水平有关。
Objective To investigate the value of serum homocysteine (Hcy) in the diagnosis of cerebral infarction and assess the severity of cerebral infarction, and to explore the possible mechanism of Hcy changes. Methods Forty patients with Mild, Moderate and Severe Cerebral Infarction were selected as the observation group. Forty cases with healthy subjects confirmed by physical examination in the same period were selected as the control group. The serum Hcy was detected by electrochemiluminescence. The frequency distribution of cystathionine-β synthase (CBS) genotypes and alleles and serum Hcy level in different CBS genotypes were compared between the observation group and the control group. Results Serum Hcy, folic acid, vitamin B12, C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and matrix metalloproteinase-9 (MMP-9) in patients with mild cerebral infarction, moderate cerebral infarction and severe cerebral infarction 9), nerve growth factor (NGF) and neurotrophic factor (NTF) were compared between two groups (P <0.05) and compared with the control group (P <0.01). The frequencies of CBS genotypes and alleles in observation group and control group were significantly different (P <0.01, P <0.05). There was no significant difference in the serum Hcy between CBS genotype and control group (P> 0.05), C / C genotype (C / T) Serum Hcy levels were significantly different (P <0.05, P <0.01). Conclusions Hcy serum level can be used as a diagnostic index of cerebral infarction, which is of great value in judging the severity of cerebral infarction. CBS gene mutation may be related to serum Hcy levels.