同型半胱氨酸、超敏C反应蛋白、低密度脂蛋白胆固醇、D-二聚体与脑梗死的关系

Relationship of high homocysteine,hypersensitive C-reactive protein,low-density lipoprotein and D-dimer with cerebral infarction

目的:探讨血清同型半胱氨酸(Hcy)、血脂、超敏C反应蛋白(hs-CRP)、凝血功能、D-二聚体的变化与脑梗死的关系。方法:收集2012年3月-2013年2月于我院住院治疗的急性脑梗死患者172例为观察组,并根据病灶大小分为大梗死组、小梗死组和腔隙性脑梗死组。分别对3组患者入院后次日晨测定血清Hcy、血脂、hs-CRP、凝血功能、D-二聚体。100例健康体检者作为正常对照。结果:脑梗死患者血清Hcy、血脂、hs-CRP、纤维蛋白原(Fib)、D-二聚体水平均高于正常对照组,APTT和TT均低于正常对照组(P<0.05)。血清Hcy水平与LDL、hs-CRP和血浆D-二聚体水平有一定相关性(r值分别为0.739,0.681和0.803,P<0.01)。大梗死组、小梗死组血清Hcy、hs-CRP、LDL和血浆D-二聚体水平明显高于腔隙性脑梗死组(P<0.05),大梗死组血浆Fib水平明显高于腔隙性脑梗死组和小梗死组(P<0.05)。脑梗死面积大小与血清Hcy、hs-CRP、LDL和血浆D-二聚体水平具有良好的相关性(r值分别为0.604、0.587、0.515、0.333,P<0.05或P<0.01)。结论:血清Hcy、hs-CRP、LDL和D-二聚体水平升高可能是脑梗死的危险因素。

Objective：To explore the relationship between levels of serum homocysteine（Hcy）, blood lipid, hypersensitive C-reactive protein （hs-CRP）, blood coagulation function, D-dimer and cerebral infarction. Methods：One hundred and seventy-two patients with acute cerebral infarction （ACI） admitted from March 2012 to February 2013 were as observation group, and they were divided into large-area infarction group, small-area infarction group, and lacunar infarction group. The levels of serum Hcy, blood lipid, hs-CRP, blood coagubility function and D-dimer of all the cerebral infarc- tion patients were measured, and compared with that of 100 normal control group. Results： The levels of serum Hcy, blood fat, hs-CRP, fibrinogen（Fib） and D-dimer were higher, and activated partial thromboplastin time （APTT） and thrombin time （TT） were lower in patients with ACI than those in normal control group （P〈0. 05）. Serum levels of Hcy was correlated with low-density lipoprotein （LDL, r= 0. 739）, hs-CRP （r= 0. 681）, and D-dimer （r= 0. 803） levels （P〈0. 01）. Serum levels of Hcy, hs-CRP, LDL and D-dimer were significant higher in large- and low-area infarction group than those of lacunar infarction group （P〈0. 05）, and Fib in large-area infarction group was higher than the other two infarction groups （P〈0. 05）. The area of cerebral infarction was significantly related with Hcy （r=0. 604）, hs-CRP （r=0. 587）, LDL （r=0. 515） and D-dimer levels （r=0. 333,P〈0. 05 or P〈0.01）. Condusions： High levels of Hcy, hs-CRP, LDL and D-dimer maybe the risk factors of cerebral infarction.