血浆Hcy水平变化对急性脑梗死患者预后的预测价值

Predictive value of plasma Hcy levels in prognostic evaluation for patients with acute cerebral infarction

目的探讨血浆同型半胱氨酸(Hcy)水平变化对急性脑梗死(acute cerebral infarction,ACI)患者预后的预测价值。方法选择2011-06—2013-12在我院住院治疗的ACI患者84例为ACI组,选取同期在我院接受健康体检的健康人84例作为正常组。利用化学发光法检测2组患者的Hcy、维生素B12(VB12)和叶酸(FA)水平,并对ACI组患者进行神经功能缺损评分(NIHSS)。将ACI组分为2组,每组42例,观察组采用VB12制剂联合FA进行治疗,对照组仅给予常规治疗。结果ACI组Hcy、FA和VB12水平分别为(22.4±7.6)μmol/L、(5.1±1.6)ng/mL和(218.2±97.2)pg/mL,正常组为(13.2±3.3)μmol/L、(7.5±2.4)ng/mL和(307.4±122.6)pg/mL,2组相比差异有统计学意义(P<0.05);治疗前脑梗死各亚组Hcy、FA和VB12水平及NIHSS评分相比差异无统计学意义(P>0.05),治疗后观察组Hcy、FA、VB12水平和NIHSS评分分别为(12.1±3.5)μmol/L、(6.3±4.2)ng/mL、(1353.4±253.1)pg/mL和(4.8±3.2)分,对照组为(18.8±4.9)μmol/L、(4.2±2.6)ng/mL、(296.3±133.4)pg/mL和(7.1±3.6)分,2组相比差异有统计学意义(P<0.05)。结论 ACI患者Hcy水平急剧增加,同时Hcy水平与ACI患者的预后情况紧密相关,Hcy水平可作为ACI患者预后的评价指标。

Objective To explore the predictive value of plasma Hcy levels in prognostic evaluation for patients with acute cerebral infarction（ACI）.Methods 84 patients with ACI in our hospital from June 2011 to December 2013 were selected as the ACI group,and 84 healthy people accepted health examination at the same period in our hospital were selected as the control group.Hcy,vitamin B12（VB12）and folic acid（FA）levels in two groups were detected by Chemiluminescence method.NIHSS score was used to evaluate the neurological deficit in ACI patients.The ACI group was divided into two groups,each group with 42cases;the observation group accepted VB12 preparation combined FA treatment,while the control group received conventional therapy.Results Hcy,FA and VB12 level in ACI group was（22.4±7.6）μmol/L,（5.1±1.6）ng/mL and（218.2±97.2）pg/mL,and was（13.2±3.3）μmol/L,（7.5±2.4）ng/mL and（307.4±122.6）pg/mL in the control group,the differences between the two groups were statistically significant（P〈0.05）;the differences of Hcy,FA and VB12 level and NIHSS score before treatment between observation group and control group were not statistically significant（P〈0.05）;after treatment,Hcy,FA,VB12 levels and NIHSS score in the observation group were（12.1±3.5）μmol/L,（6.3±4.2）ng/mL,（1353.4±253.1）pg/mL and（4.8±3.2）points,respectively,and was（18.8±4.9）μmol/L,（4.2±2.6）ng/mL,（296.3±133.4）pg/mL and（7.1±3.6）points respectively in the control group,the differences between the two groups were statistically significant（P〈0.05）.Conclusion Hcy levels increase dramatically in patients with ACI,while Hcy level is closely related to prognosis in patients with ACI.Hcy levels can be detected for ACI prognostic evaluation.