360例脑卒中患者高同型半胱氨酸血症发生率及相关因素分析

In 360 stroke patients with hyperhomocysteinemia prevalence and related factors analysis

目的调查360例脑卒中住院患者高同型半胱氨酸(Hcy)血症的发生率及其意义。方法选择2010年8月至2011年6月神经内科住院的患者为研究对象,共收集有效病例360例,脑梗死组260例,脑出血组100例,另选同期住院非脑卒中患者200例为对照组,测定各组Hcy、GLU、TG、CHOL、HDL、LDL-C、FIB的水平。结果脑梗死组和脑出血组的Hcy含量分别为(19.08±10.33)umol/L、(18.76±10.23)umol/L,与对照组相比显著升高(P<0.01)。脑卒中组的血浆FIB含量与对照组相比差异亦具有统计学意义(P<0.01)。但脑卒中组GLU、TG、CHOL、HDL、LDL-C水平与对照组比较,差异无统计学意义(P>0.05)。脑梗死组和脑出血组高同型半胱氨酸血症发生率均高于对照组(P<0.01)。结论高同型半胱氨酸血症是脑卒中的独立危险因素,高同型半胱氨酸致血浆纤维蛋白原升高,是造成脑梗死患者血液黏度升高的主要原因。

Objective To investigate the incidence rate of hyperhomocysteinemia （Hcy） in the 360 inpatients with stroke and the clinical significance as well. Methods Patients with stroke in the neurologic department of our hospital from Aug. , 2010 to June, 2011 were chosen as the research objects. Among the 360 cases in effect, 260 cases were the cerebral infarction group and 100 cases the cerebral hemorrhage group ; besides 200 contemporary non - stroke patients in the neurologic department were chosen as the control group. The levels of Hcy, GLU, TG, CHOL,HDL, LDL - C and FIB of the three groups were respectively detected. Results Hcy contents of the cerebral infarction group and the cerebral hemorrhage group were respectively 19.08 ± 10.33umol/L, 18.76 ± 10.23umol/L,obviously higher than the control group, which was of statistical significance （P 〈 0.01 ）. FBI contents of the former two groups, evidently higher than contents of the control group, which was also of statistical significance （P〈0.01）. However, in terms of levels of GLU, TG, CHOL,HDL, LDL-C, the difference between the former two groups and the control group was of no statistical significance （ P 〉 0.05 ）. The incidence rates of hyperho- mocysteinemia in the cerebral infarction group and the cerebral hemorrhage group were both higher than that in the control group, which was of statistical significance （P 〈 0.01 ）. Conclusion Hyperhomocysteinemia is an independent risk factor in the stroke and that homocysteine contributes to the increase of the plasma fibriuogen is a primary cause for the upgrading of blood viscosity of cerebral infarct.