脑梗死患者血清同型半胱氨酸和尿酸含量分析及其临床意义

The levels of serum homocysteine and uric acid and clinical significances in patients with cerebral infarction

目的通过分析脑梗死患者血清同型半胱氨酸(Hcy)和尿酸(UA)的含量,以初步探讨其临床意义。方法110例健康人群作为对照组,同期108例脑梗死患者根据梗塞面积分为大面积脑梗死组(57例)和非大面积脑梗死组(51例)。所有受检者均检测血清Hcy和UA,并对脑梗死组患者进行NIHSS评分来评价神经功能缺损情况。比较分析脑梗死组与对照组、不同脑梗死面积组、神经功能缺损严重和轻微组的血清Hcy和UA水平的差异,并对脑梗死组的NIHSS评分和血清Hcy、UA分别进行相关性分析。结果脑梗死组血清Hcy和UA较对照组均明显升高,差异有统计学意义(P<0.05);大面积脑梗死组与非大面积脑梗死组相比,血清Hcy、UA值也明显升高(P<0.05)。神经功能缺损严重者血清Hcy较缺损轻微者明显增高,差异有统计学意义(P<0.05),而血清UA水平无显著差异(P>0.05)。相关性分析结果显示血清Hcy与NIHSS评分均呈显著正相关(r=0.35,P<0.05),而血清UA与NIHSS评分无显著相关性(r=0.17,P>0.05)。结论检测脑梗死患者血清Hcy和UA有一定的临床价值,尤其是血清Hcy与脑梗死面积和NIHSS评分可能有关联,而血清UA在脑梗死中的意义有待进一步的研究证实。

Objective To evaluate the clinical significance of serum homocysteine（Hcy）and uric acid（UA）levels in patients with cerebral infarction. Methods 108 patients diagnosed cerebral infarction were divided into 2 groups accord- ing to infarct size：the massive cerebral infarction group（57 cases）and non-massive cerebral infarction group（51 cases）, while 110 healthy people in the same period as a control group. We evaluated neurological deficit through NIHSS scores in patients. Serum Hcy and UA were observed in all people enrolled to analyze their changes and relationship to infarct size and NIHSS scores. Results The contents of serum Hcy and UA were higher significantly in cerebral infarction group,compared to control group（t= 20. 55,26. 99,P= 0. 00,0. 00〈0. 05）. And similar kind changes were found in massive cerebral infarction subgroup when compared to non massive cerebral infarction group （t= 11. 68,2. 17, P= 0. 00,0. 03〈0. 05）. Moreover,in the severe neurological deficit（NIHSS scores≥7）group, the contents of serum Hcy were higher significantly and the contents of serum UA were not, compared to the mild neurological deficit（NIHSS scores%7）group. Correlation analysis showed that the serum Hcy positively correlated to NIHSS scores and the serum UA did not. Conclusion Our findings suggested that serum Hcy and UA levels are associated with cerebral infarction and especially,that serum Hcy levels contributed to the infarct size and NIHSS scores. However, the conclusive values of serum UA remains to be determined in further studies.