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目的：观察脑卒中患者血清同型半胱氨酸（ Hcy）、神经元特异性烯醇化酶（ NSE）、血小板活化因子（ PAF）水平变化及临床意义。方法选取2013年6月—2015年6月陕西省汉中职业技术学院附属医院内二科收治脑卒中患者120例为观察组，根据美国国立卫生研究院卒中量表（ NHISS）评分分为轻度卒中亚组45例，中度卒中亚组42例，重度卒中亚组33例。另选取同期健康体检者100例为对健康照组，采用ELISA法测定2组血清Hcy、NSE、PAF水平，并分析其与NHISS评分、Barthel指数（ BI）、格拉斯哥昏迷量表评分（ GOS）的关系。结果观察组患者血清Hcy、NSE、PAF水平显著高于健康对照组（ t ＝12．986、14．278、10．425， P ＜0．05）；且重度卒中亚组患者高于轻中度卒中亚组患者（ F ＝8．363、9．123、10．562， P ＜0．05）；脑卒中存活亚组患者显著低于病死亚组（ t ＝11．464、9．758、8．923， P ＜0．05）。脑卒中患者入院后第3天NHISS评分低于入院时（ P ＜0．05），而BI评分、GOS 评分高于入院时（ P ＜0．05）。经Pearson单因素分析显示，脑卒中患者血清Hcy与NHISS评分、BI评分、GOS评分呈正相关（ r ＝0．345、0．369、0．337， P ＜0．05），NSE、PAF与NHISS评分呈正相关（ r ＝0．372、0．342， P ＜0．05），与BI评分、GOS评分无相关性（ r ＝0．122、0．108、0．013、0．098， P ＞0．05）。结论脑卒中患者血清Hcy、NSE、PAF水平与神经功能缺损程度有密切的关系，可作为其病情进展及预后的评价指标。“,”Objective To observe the levels of serum homocysteine ( Hcy ) ,neuron specific enolase ( NSE ) and platelet activating factor ( PAF) in stroke patients and its clinical significance .Methods Selected from June 2013 to 2015 June, Shanxi Province Hanzhong vocational and technical college affiliated hospital admitted 120 casesof patients with stroke as the observation group, according to the NHISS score; they were divided into mild stroke subgroup (45 cases), moderate stroke subgroup of 42 cases, severe stroke subgroup of 33 cases.Select another 100 cases of health people of the corresponding period as on health group, by ELISA method to determine of serum Hcy, NSE and PAF level, and to analyze the NIHSS score, Barthel Index ( BI) , Glasgow Coma table score ( GOS) .Results Observation group’ s level of serum Hcy, NSE and PAF levels were significantly higher than those in the healthy control group ( t =12.986, t=14.278, t =10.425, P <0.05), and severe stroke subgroup were higher than mild to moderate stroke subgroup patients ( F =8.363, F =9.123, F =10.562, P <0.05);stroke survival subgroup of patients was significantly lower than that of mortality subgroup ( t =11.464, t =9.758, t =8.923, P <0.05).Stroke patients admitted to hospital third days after admission’s NHISS score was lower (P <0.05), while the BI score, GOS score higher than the admission ( P <0.05).By Pearson univariate analysis showed that stroke patients’ serum Hcy and NIHSS score, Barthel Index (BI) and GOS scores were positively related ( r =0.345, r =0.369, r =0.337, P <0.05) and neuron specific enolase (NSE), PAF and NIHSS score was positively correlated (r =0.372, r =0.342, P 0.05).Conclusion The levels of serum Hcy, NSE and PAF were closely related with the degree of neurological deficits, which can be used as the evaluation index of the progression and prognosis of stroke patients.