高同型半胱氨酸血症与老年人脑梗死的相关性研究

Correlation study of hyperhomocysteinemia and cerebral infarction in elderly patients

目的研究血浆同型半胱氨酸（Hey）水平与老年人脑梗死的关系。方法测定92例老年人脑梗死患者，其中腔隙性脑梗死（脑小动脉病变型）24例，单发脑梗死（脑大动脉病变型）52例，复发性脑梗死16例和30例健康对照者空腹血浆Hcy、叶酸及维生素B12水平。结果单发脑梗死组、复发性脑梗死组血浆Hcy水平显著高于对照组（P〈0．01），而腔隙性脑梗死组与对照组比较差异无统计学意义（P〉0．05），且复发性脑梗死组显著高于单发脑梗死组（P〈0．05）。单发脑梗死组、复发性脑梗死组血浆叶酸及维生素B12水平显著低于对照组（P〈0．01），而腔隙性脑梗死组与对照组比较差异无统计学意义（P〉0．05），且复发性脑梗死组显著低于单发脑梗死组（P〈0．05）。结论高Hcy血症与老年人脑梗死的危险性增加有关，且与脑动脉粥样硬化性大血管病变有较强联系，并可能是脑梗死复发的一个独立危险因素；血浆Hcy水平和叶酸、维生素B12浓度呈负相关。

Objective To study the relationship between plasma homocystine level and cerebral infarction（CI） in elderly patients. Methods The plasma Hey, folaein and vitamin B12 levels of 92 CI patients, including 24 cases of lacunarinfarction（ small-arterydisease）, 52 cases of single cerebral infarction （large-artery disease）, 16 cases of recurrent cerebral infarction and 30 cases of healthy controls in elderly patients. Results Plasma levels of Hcy in single cerebral infarction and recurrent cerebral infarction group,were significantly higher than that in control group （ P 〈 0. 01 ）, but there were no significant differences between lacunar infarction group and the control group （P 〉 0.05 ） , and that in recurrent cerebral infarction group was significantly higher than single cerebral infarction group （P 〈 0. 05 ）. Plasma levels of folacin and vitamin B12 in single cerebral infarction group and recurrent cerebral infarction group were significantly lower than those in control group （P 〈 0. 01 ）, but there were no significant differences between lacunarinfarction group and control group （ P 〉 0. 05 ） , and that in recurrent cerebral infarction group was significantly lower than single cerebral infarction group （P 〈 0. 05 ）. Conclusions Hyperhomocysteinemia is associated with the increased risk of cerebral infarction, and there is a strong association between elevated homocystine and atheroselerotic vascular disease. Hyperhomocys- teinemia maybe an independent risk factor of recurrent cerebral infarction; Plasma Hey and folie acid, vitamin B12 concentrations are negatively correlated.