同型半胱氨酸表达水平对缺血性脑卒中神经功能缺损程度的影响

The effects of the expression level of homocysteine on the degree of nervous functional defect of the patients with ischemic stroke

目的观察和分析同型半胱氨酸(Hcy)表达水平对急性缺血性脑卒中(AIS)患者神经功能缺损程度的影响。方法选取300例AIS患者作为研究对象,在入院时,应用改良Rankin评分(mRS)将纳入的患者分为轻症组(mRS评分≤3分)和重症组(mRS评分>3分),两组分别纳入202例和98例患者。对两组患者血液标本中的Hcy、血糖、甘油三酯、胆固醇等指标进行检测和比较,并对两组患者中高同型半胱氨酸血症的发病率进行比较。结果重症组患者的血浆Hcy水平显著高于轻症组患者(P<0.05),两组患者中高同型半胱氨酸血症的发病率分别为38.8%和9.4%,重症组显著高于轻症组(P<0.05);患者入院时的神经功能缺损程度与其血浆Hcy水平(r=0.453,P<0.05)、血压水平(r=0.461,P<0.05)、胆固醇水平(r=0.385,P<0.05)、血糖水平(r=0.059,P<0.05)均呈正相关关系。结论血浆Hcy水平的上升可能是与AIS患者神经功能缺损症状相关的因素,高血浆Hcy水平、高血压、高胆固醇血症、糖尿病均是与AIS患者神经功能缺损症状具有相关关系的危险因素。

Objective To observe and analyze the effects of the expression level of homocysteine （Hcy）on the degree of nervous functional defect of the patients with acute ischemic stroke （AIS）.Methods 300 cases of AIS patients were selected as the research objects.At the time of admission,the modified Rankin score （mRS）was employed to divided the patients into the mild group （mRS score≤3）and the severe group （mRS score〉3）.202 patients and 98 patients were included into the two groups respectively.The blood glucose,triglyceride,cholesterol,Hcy levels of the patients in the two groups were detected and compared and the incidence of hyperhomocysteinemia of the patients in the two groups were compared.Results The plasma Hcy level of the patients in the severe group was significantly higher than that of the mild group （P 〈0.05）.The incidences of hyperhomocysteinemia the patients in the two groups were 38.8% and 9.4% respectively.The incidence of the severe group was significantly higher than that of the mild group （P 〈0.05）;the nervous functional defect degree of the patients on admission were positively correlated with the plasma Hcy level （r=0.453,P 〈0.05）,blood pressure （r=0.461,P 〈0.05）,cholesterol level （r=0.385,P 〈0.05）,blood glucose level （r=0.359,P 〈0.05）.Conclusion The rise of plasma Hcy level may be the factors associated with the symptoms of nervous functional defect of patients with AIS.The higher plasma Hcy level,hypertension,hypercholesterolemia,diabetes were the risk factors associated with the symptoms of nervous functional defect of patients with AIS.