高同型半胱氨酸血症与脑梗死复发的关系

Relationship between hyperhomocysteinemia and the recurrence of cerebral infarction

目的探讨高同型半胱氨酸血症(Hhcy)与脑梗死复发的关系。方法按血浆同型半胱氨酸(Hcy)水平,将139例急性脑梗死患者分为Hhcy组(42例,血Hcy≥15μmol/L)和非Hhcy(NHhcy)组(97例,血Hcy<15μmol/L)。给予入组者抗血小板治疗,以及控制已知的脑血管病危险因素等治疗;随访5年,观察两组脑梗死复发率及死亡率,分析影响脑梗死复发的危险因素。结果 Hhcy组脑梗死复发率(38.1%)和死亡率(19.0%)明显高于NHhcy组(15.5%,6.1%)(P<0.05～0.01)。Logistic回归分析显示,脑梗死复发与Hhcy(OR=1.110,95%CI:1.051～1.171,P<0.01)及糖尿病(OR=4.816,95%CI:1.693～13.697,P<0.01)有关。结论 Hhcy是脑梗死复发的独立危险因素之一。

Objective To explore the relationship between hyperhomocysteine（Hhcy） and the recurrence of cerebral infarction（CI）.Methods According to the level of plasma homocysteine（Hcy）,139 acute CI patients were divided into Hhcy group（42 cases,Hcy≥15 μmol/L） and non-Hhcy（NHhcy） group（97 cases,Hcy15 μmol/L）.All of them received the treatment with antiplatelet and control risk factors of cerebrovascular disease.Then the recurrence rate of CI and the mortality of the 2 groups were observed by 5 years followed-up.The risk factors of CI recurrence were analyzed.Results The recurrence rate of CI and the mortality in Hhcy group（38.1%,19.0%） were significantly higher than that in NHhcy group（15.5%,6.1%）（P0.05-0.01）.Logistic analysis showed that the recurrence of CI was related with Hhcy（OR=1.110,95%CI： 1.051-1.171,P0.01） and diabetes mellitus（OR=4.816,95%CI： 1.693-13.697,P0.01）.Conclusion Hhcy is one of the independent risk factors of CI recurrence.