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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(χ~2=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(χ~2=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。
Objective To observe the plasma homocysteine (Hcy) level in patients with cerebral infarction and to explore the relationship between Hcy level and the incidence and prognosis of cerebral infarction, and to provide a reference for the early monitoring and treatment of cerebral infarction. Methods Ninety-two patients with cerebral infarction who were treated in Wenling First People’s Hospital from January 2013 to January 2014 were enrolled. Eighty healthy volunteers were selected as the control group, and the fasting plasma Hcy level was compared between the two groups. Ninety-two patients with cerebral infarction were scored according to the score of clinical neurological deficit, and plasma homocysteine levels and short-term death and disability were compared among patients with different degrees of impairment. Results The mean plasma Hcy in the experimental group was (18.13 ± 4.51) μmol / L, which was significantly higher than that in the control group (9.24 ± 2.88 μmol / L, χ ~ 2 = 15.712, P = 0.017) The plasma levels of Hcy in the test group were (15.83 ± 2.51) μmol / L, (18.99 ± 4.24) μmol / L and (13.13 ± 3.98) μmol / L, respectively) (16.31 ± 1.54) μmol / L, mean plasma Hcy level was (20.43 ± 3.01) in the patients with disability or death, μmol / L, the difference was statistically significant (χ ~ 2 = 22.571, P = 0.008). Conclusions The level of plasma homocysteine in patients with cerebral infarction is significantly increased, which is correlated with the degree of neurological deficits. It is a sensitive indicator of disease course and prognosis in patients with cerebral infarction.