老年脑卒中患者同型半胱氨酸水平及与神经功能缺损程度关系研究

Relationship between homocysteine and the degree of nervous functional defect in the elderly patients with stroke

目的探讨老年脑卒中患者同型半胱氨酸(Hcy)水平及其与神经功能缺损程度的关系。方法采用循环酶法,测定154例脑卒中患者(其中急性脑梗死组87例,脑出血组67例)和90例健康体检者的Hcy水平;对154例脑卒中患者进行神经功能缺损评分,按照评分结果分为重度、中度、轻度3组。结果急性脑梗死组的Hcy水平高于健康对照组,差异有统计学意义(P<0.05);脑出血患者的Hcy高于健康对照组,差异有统计学意义(P<0.05);急性脑梗死组、脑出血组的Hcy水平无明显差异(P>0.05)。神经功能缺损重度32例、中度50例、轻度72例。脑卒中神经功能缺损程度不同者之间Hcy水平比较,差异有统计学意义(P<0.05)。结论脑卒中的发生与Hcy水平有非常密切关系,Hcy是脑出血、脑梗死等脑血管疾病的高危因素。脑卒中患者血清Hcy水平反映病情的严重程度,有助于评估脑卒中预后,指导临床治疗。

Objective To investigate the relationship between homocysteine and the degree of nervous functional defect in the elderly patients with stroke. Methods A case-control study was conducted. 154 patients with stroke including 87 patients with acute cerebral infarction and 67 cases with cerebral hemorrhage and 90 cases of healthy persons were selected. Hcy level was detected by enzymatic cycling method. Neurological function was evaluated according to the scores of the nerve function assessment. Results Hcy levels in acute cerebral infarction group and cerebral hemorrhage group were higher than that in healthy controls（ P〈0. 05）,while the difference was of no statistically significance between acute cerebral infarction group and cerebral hemorrhage group. There were 32 sever neural functional defect cases and 50 moderate cases and 72 mild cases. Hcy levels showed significant difference between the patients with different degrees of neural function defect. Conclusions High level of serum Hcy is an independent risk factor for stroke,and the serum Hcy levels could help to evaluate the prognosis of stroke,and to guide the clinical treatment.