脑卒中患者同型半胱氨酸水平及其影响因素研究

Study on the association between serum concentrations of homocysteine and relative factors in stroke patients.

目的探讨脑卒中患者血清同型半胱氨酸水平与影响因素的关系。方法选择229例脑卒中急性期住院患者,采用汉密顿抑郁量表、汉密顿焦虑量表、长谷川痴呆量表、临床神经功能缺损评分、Barthel日常生活能力指数和一般情况调查表进行测查,并检测各项血液指标。结果高同型半胱氨酸血症患者为91例(39.7%)。与正常组相比,在年龄、性别、教育程度、饮酒、吸烟、糖尿病史、叶酸、维生素B12、肌酐、超敏C反应蛋白、长谷川痴呆评分、抑郁睡眠因子分方面差异均有统计学意义(P<0.05)。多元Logistic回归方程是高同型半胱氨酸血症(Y)=+0.809教育程度+0.032年龄+0.014肌酐-0.001维生素B12-0.195叶酸-1.012性别-1.854。结论教育程度低、高龄、肌酐高、维生素B12和叶酸低的男性脑卒中患者更容易出现高同型半胱氨酸血症;同型半胱氨酸水平升高可能与痴呆和抑郁的某些征候群有关,与焦虑关系不大。

Objective To study the association between serum concentrations of homocysteine （Hcy） and relative factors in stroke patients. Methods A sample of 229 in-hospital stroke patients was investigated with 17-item Hamilton Depression Rating Scale（HAMD） , 14-item Hamilton Anxiety Rating Scale, Hasegawa Dementia Scale（HDS） , Barthel Index and Neural Defection Scale. Serum concentrations of homocysteine and other blood tests were checked in all patients. Results The hyperhomocysteinemia was detected in 91 of 229 stroke patients （39.7 % ）. There were significant different between high Hcy and normal groups in age, sex, education, alcohol consumption, smoking, history of diabetes mellitus, folic acid, B vitamins, creatinine, C-active proteine, HDS score and sleep factor score of HAMD（P 〈0. 05）. The logistic regression equation is that hyperhomocysteinemia （Y） = ＋ O. 809 × education ＋ 0. 032 × age ＋ 0. 014 × creatinine -0. 001 × vitamine B12 - 0. 195 × folic acid - 1. 012 × sex - 1. 854. Conclusions Those elder male with poor education, hypercreatinine, low folic acid and B vitamins have higher risk of being hyperhomocysteiuemia in stroke patients. Hyperhomocys-teinemia may be associated with dementia and some symptoms of depression, but not anxiety.