复发性脑梗死与血浆Hcy

Relationship Between Recurrence of Cerebral Infarction and Hyperhomocysteinemia

目的:观察脑梗死初发、复发患者血浆Hcy水平,探讨脑梗死复发与血浆Hcy的关系。方法:用荧光偏振免疫法(FPIA)测定400例急性脑梗死患者及200例非急性脑卒中的对照组患者的血浆Hcy水平,并进行分析。结果:①各类型急性脑梗死患者血浆Hcy均高于非急性脑卒中患者(P<0.01);各类型脑梗死患者之间Hcy无显著性差异(P>0.05);②脑梗死复发患者血浆Hcy高于初发患者(P<0.01),且高Hcy比率亦高于初发患者(P<0.05);③一年内和一年后复发患者血浆Hcy无显著性差异(P>0.05);④各类型脑梗死复发患者之间血浆Hcy无显著性差异(P>0.05);血栓形成性脑梗死复发患者高Hcy比率略高于其他类型脑梗死(P>0.05)。结论:脑梗死复发患者血浆Hcy高于初发患者提示脑梗死复发与血浆Hcy升高有一定关系,高Hcy是脑梗死复发的独立性危险因素。

Objective To study the relationship between hyperhomocysteinemia （HHcy） and recurrent cerebral infarction （RCI）. Methods Plasma Hcy levels were determined with fluorescence polarization immunoassay （FPIA） technology in 400 patients with acute cerebral infarction （ACI） and 200 non - ACI patients （ as controls）. Results ①Among these 400 patients with acute cerebral infarction （ACI） , 303 patients had their infarction for the first time and the rest （97） had a recurrent one. Plasma levels of Hcy in all these patients were significantly higher than those in the controls （ P 〈 0.01 ） and there were no significant differences between the levels in patients with various types of infarction （ thrombotic, embolic ） （P 〉 0.05 ）. ②Plasma Hcy levels in patients with recurrent infarction were significantly higher than those in patients with infarction for the first time （ P 〈 0.01 ）, the percentage of the subjects in the recurrent group with higher than normal Hcy plasma levels was also higher than that in group with first time infarctions （P 〈 0.05）. ③Among the recurrent patients, there were no significant differences between the plasma Hcy levels in those recurred within one year and those recurred beyond one year （P 〉 0.05 ）. ④Among the recurrent patients, Plasma Hcy levels in patients with thrombosis were slightly higher than those in patients with recurrence due to other causes but not significant （P 〉 0.05 ）. Conclusion HHcy may be an independent risk factor associated with RCI.