200例青年脑梗死患者CISS分型与高同型半胱氨酸的关系

Correlation between different CISS classifications and high homocysteine in youth cerebral infarction

目的通过分析不同CISS分型(Chinese ischemic stroke subclassification,CISS)青年脑梗死与高同型半胱氨酸(high homocysteine,HHcy)的关系,为青年脑梗死的病因诊断及治疗提供依据。方法选择我院住院治疗的青年脑梗死患者200例作为实验组,于我院同期进行健康体检者作为对照组,测定Hcy水平,比较两组之间的Hcy差异;实验组进行CISS分型,各型进行NIHSS评分,应用方差分析及q检验比较不同CISS分型的青年脑梗死患者NIHSS评分及Hcy水平的差异。结果实验组与对照组的Hcy水平分别为21.38±3.32μmol/L、11.65±2.74μmol/L,两组Hcy水平差异有统计学意义(P=0.0000)。在实验组CISS分型中,与其他四型(PAD,CS,OE,UE)相比,LAA型Hcy水平升高,NIHSS评分升高,差异有统计学意义(相应F=209.03,P=0.0000;F=2410.54,P=0.0000),但其他四个亚型(PAD、CS、OE、UE)之间比较,差异无统计学意义(P均>0.05)。结论高同型半胱氨酸是青年脑梗死的危险因素之一,血浆同型半胱氨酸水平与青年脑梗死的神经功能缺损程度相关,LAA型病情更重,同型半胱氨酸水平更高,应提高重视。

Objective Provide the basis for clinical pathogeny diagnosis and discuss effective ways of curing the youth cerebral infarction in different CISS classifications through analysis of the correlation between the youth infarction in different CISS classifications and high homocysteine（ Hcy）. Methods The selected young patients who diagnosed with cerebral infarction and admitted to the hospital were regarded as the study group,and the other 200 persons picked accepted health examination in our hospital in the corresponding period were regarded as the control group,then the 200 patients were grouped according to CISS classification; Hcy levels were determined and NIHSS scale was applied to score. Results Serum Hcy levels in young patients with cerebral infarction was 21. 38 ± 3. 32 μmol / L,serum Hcy levels in control group was11. 65 ± 2. 74 μmol / L.. Serum Hcy levels in young patients with cerebral infarction were significantly higher（ P =0. 0000）. The statistical significance in comparative difference was found in the serum Hcy level and NIHSS score of large artery atherosclerotic（ LAA） subtype from CISS classification（ F = 209. 03,P = 0. 0000; F = 2410. 54,P = 0. 0000） and the other four subtypes,but such significance was absent among the other four subtypes（ PAD、CS、OE、UE）（ P〉0. 05）.Conclusion Our finding suggested that High Hcy was one of the causes of cerebral infarction in young people and the degreed of disablity neurology functional disablity was related with elevated plasma Hcy level,LAA type is more serious,homocysteine level is higher,we should pay more attention to these patients.