高同型半胱氨酸血症与脑梗死复发率关系的随访研究

The follow-up research on the relationship between hyperhomocysteinemia and the recurrence rate of cerebral infarction after previous stroke

目的探讨高同型半胱氨酸血症(Hhcy)与再发脑梗死危险性的关系,进而为脑梗死的防治提供新的理论依据。方法测定151例急性脑梗死患者和52名健康对照者空腹血浆总同型半胱氨酸(tHcy),以此结果将患者分为 Hhcy 组和非 Hhcy 组,对两组患者5年中脑梗死复发情况进行跟踪观察。结果 Hhcy 组5年复发率显著高于非 Hhcy 组(Hhcy 组患者为44.26%,非 Hhcy 组患者为12.22%,P<0.01),再经 Logistic 回归分析发现,tHcy 升高是脑梗死复发的独立危险因素(P<0.01;OR=1.229,95%CI:1.146～1.317)。结论 Hhcy 与卒中后再发脑梗死密切相关。

Objective To explore the possible effect of the plasma homocysteine level on the risk of recurrent cerebral infarction patients by follow-up research in hope for finding a new theoretical evidence for the therapy and the prophylaxis of cerebral infarction. Methods We determined the free plasma total homocysteine （tHcy） of 151 patients with acute cerebral infarction and 52 age- and gender-matched healthy controls by high-performance liquid chromatography, then we divided the patients into hyperhomocysteinemia （Hhcy） group and no hyperhomocysteinemia （Nhhcy） group according to the outcome. Within a 5-years follow-up period, we observed the recurrence of cerebral infarction in the 2 groups. Results There was no statistical deference in common information between Hhcy and Nhhcy group. But the recurrence rate of the Hhcy group, being 44. 26%, was significantly higher than 12. 22% of Nhhcy group （P 〈0. 01 ）. By forward stepwise Logistic analysis, we found that the increased tHcy was a dependent risk factor of the recurrent cerebral infarction （P 〈 0. 01 ; OR = 1. 229, 95% CI： 1. 146-1. 317）, so was hypertension and diabetes mellitus. But in our research hyperlipidemia did not show the statistical correlation with the high recurrence of cerebral infarction, probably due to relatively small sample size short observing time. Conclusion Hhcy is closelv correlated with the recurrent cerebral infarction after nrevious ischemic stroke.