高同型半胱氨酸血症与缺血性脑血管病危险因素的关系及干预治疗

Correlation between the Hyperhomocystinemia and Risk Factors of Ischemic Cerebrovascular Disease and Intervention Treatment

目的探究高同型半胱氨酸血症与缺血性脑血管病危险因素及干预治疗。方法随机选取该院2014年3月—2016年9月间收治的80例缺血性脑血管疾病患者进行研究,腔隙性脑梗死35例,短暂性脑缺血发作27例,急性脑梗死18例,另选取同期在该院治疗的50例非脑血管疾病患者作为对照组,比较两组同型半胱氨酸(Hcy)水平,对缺血性脑血管病危险因素进行对比。对HHcy伴有传统因素对缺血性脑血管病的影响进行分析,提出治疗建议。结果 HHcy合并高血压,有HHcy为23.5%,对照组为16.7%;糖尿病有HHcy为45.0%,对照组为10.0%;高LDL有HHcy为40.0%,对照组为14.3%,这些因素是诱发缺血性脑血管病重要因素(P<0.05);A组治疗治疗3周后Hcy水平(27.41±4.21),B组治疗3周后(27.54±2.14),G组为(30.14±5.23),使用维生素的A组与B组Hcy水平明显降低,差异无统计学意义(P>0.05)。结论 HHcy产生与缺血性脑血管疾病其他危险因素有关,包括高血压、糖尿病等,服用2种以上维生素治疗较服用1种维生素及未服用维生素治疗效果显著。

Objective To study the correlation between the hyperhomocystinemia and risk factors of ischemic cere- brovascular disease and intervention treatment. Methods 80 cases of patients with ischemic cerebr0vaseular disease admitted and treated in our hospital from March 2014 to September 2016 were randomly selected including 35 cases with lacunar infarction, 27 cases with transient ischemic attack and 18 cases with acute cerebral infarction, and 50 cas- es of patients with non- cerebrovascular disease treated in our hospital at the same period were selected as the control group, and the Hcy level and risk factors of ischemic cerebrovascular disease were compared between the two groups, the effect of HHcy with traditional factors on ischemic cerebrovascular diseases was analyzed and the treatment sug- gestions were put forwards. Results 23.5% had HHcy in patients with hypertension and 16.7% in the control group; 45.0% had HHcy in patients with diabetes and 10.0% in the control group; 40.0% had HHcy in patients with high LDL and 14.3% in the control group, and these factors were the important factors of ischemic cerebrovascular diseases （P〈 0.05）, and the Hcy level after 3 -week treatment was respectively （27.41 ±4.21 ）, （27.54±2.14） and （30.14±5.23 ） in the group A,B and G, and the Hcy level in the group A and group B using vitamin obviously decreased, and the differences had statistical significance （P〉0.05）. Conclusion The production of HHcy is related to the risk factors of ischemic cerebrovascular disease including hypertension and diabetes, and the treatment effect of patients taking vitamins more than two kinds is more obvious than that of patients taking vitamins of one kind and patients without taking vitamins.