血清同型半胱氨酸检测在中老年急性脑梗死中的应用

Application of Serum Homocysteine in Middle-aged and Aged Patients with Acute Cerebral Infarction

目的：研究血清同型半胱氨酸（HCY）在中老年急性脑梗死中的应用。方法收集132例急性脑梗死患者和120名健康体检者（对照组）血液标本，按年龄分中年组（45～59岁）和老年组（≥60岁）。采用循环酶法检测血清HCY水平。结果急性脑梗死患者血清HCY水平中年组、老年组分别为21.50±4.55μmol/L、22.72±6.45μmol/L，差异无统计学意义（P＞0.05），但均明显高于中年对照组、老年对照组的11.78±1.38μmol/L、16.63±2.17μmol/L，差异有统计学意义（P＜0.05）。老年对照组HCY水平高于中年对照组，差异有统计学意义（P＜0.05）。中年急性脑梗死患者93.55%HCY升高，但老年急性脑梗死患者仅67.14%升高，灵敏度差异有统计学意义（P＜0.05），HCY对老年急性脑梗死诊断的Kappa指数＜0.60，对中年急性脑梗死诊断的灵敏度、特异度、准确度均＞90%，Kappa指数0.86。结论急性脑梗死患者血清HCY水平明显升高，HCY对中年脑梗死的诊断和警示价值高。

Objective To explore the application of serum Homocysteine （HCY） in acute cerebral infarc-tion of middle-aged and aged people. Methods Blood samples from 132 acute cerebral infarction cases and 120 healthy cases （control group） were collected. All cases were divided into middle-aged group （45～59 years old） and aged group （≥60 years old）. The serum HCY was detected by circle enzyme method. Results The serum HCY level were similar in middle-aged group and aged group with acute cerebral infarction （21.50±4.55μmol/L vs 22.72±6.45μmol/L）, however it was higher than control group （P〈0.05）. The serum HCY level were only 11.78±1.38μmol/L in healthy middle-aged group, while 16.63±2.17μmol/L in elderly healthy people. The serum HCY in healthy elderly group was signiifcantly higher than that in healthy middle-aged group （P〈0.05）. 93.55%middle-aged patients with acute cerebral infarction were showed with HCY increased, while only 67.14%in elderly patients （P〈0.05）. The Kappa index was〈0.60 in elderly patients with acute cerebral infarction if HCY were used to diagnose, while in middle-aged patients the sensitivity, speciifcity and accuracy were〉90%, the Kappa index is 0.86. Conclusion The serum HYC in acute cerebral infarction was increased. It was useful in the diagnosis and caution of acute cerebral infarction in middle-aged people.