脑梗死TOAST病因分型与高同型半胱氨酸血症相关性分析

To analyze the correlation between the TOAST etiology of the Cerebral Infarction and the Homocysteine

目的探讨脑梗死TOAST病因分型与高同型半胱氨酸血症相关性。方法选择2013年1月-2015年12月确诊为脑梗死的患者11,0例组成研究组,根据TOAST病因分型可分为大动脉粥样硬化性卒中(LAA组)、心源性脑栓塞(CE组)和小动脉闭塞性卒中或腔隙性卒中(SAA组)三个研究小组,选择同期进行体检且结果健康的退伍军人35例组成对照组,均进行同型半胱氨酸(Hcy)浓度水平测定,对结果进行统计分析。结果与对照组分别两两比较,三个研究小组的Hcy浓度水平均明显升高,差异具有统计学意义(P<0.05)。LAA组患者的Hcy浓度水平均明显高于另外两个小组,差异具有统计学意义(P<0.05),但CE组患者和SAA组患者的Hcy浓度水平无明显统计学差异(P>0.05)。患者Hcy检测的特异度较高,超过90.00%。LAA组患者的敏感度明显高于另外两个小组,差异具有统计学意义(P<0.05),但CE组患者和SAA组患者的敏感度两两比较无明显差异。LAA组患者的Youden指数结果最高。结论 Hcy对于LAA、CE和SAA三种类型脑梗死分型疾病的辅助诊断均具有一定的临床价值,其中高Hcy血症与LAA的大动脉粥样硬化形成具有较强的相关性,是引起脑梗死的原因之一。

Objective To analyze the correlation between the TOAST etiology of the Cerebral Infarction and the Homocysteine. Methods Choosing 110 cases of patients with Cerebral Infarction for the experimental group,according to the TOAST etiology we can divided into the LAA group, CE group and SAA group,and choosing 35 cases healthy check-up for the control group, testing the Homocysteine, analyze the results comprehensively. Results Compare to the normal group,there were obviously increased of the Homocysteine concentration levels of the three experimental group（P〈0.05）. The Homocysteine concentration levels of the LAA group was obviously higher than the other two groups （P〈0. 05） ,but there was no obviously differences between the CE group and the SAA group（P〉0.05）. The specificity of the Hcy was mor than 90.00%. The sensitivity of the LAA group was obviously higher than the other two groups （P〈0.05） ,but there was no obviously differences between the CE group and the SAA group（P〉0.05）. The Youden of the LAA group was the highest. Conclusion There is a certain clinical value of the Homocysteine for the LAA,CE and SAA auxiliary diagnosis,and there has strong correlation between the hyperhomocystinemia and the LAA＇s Large artery atherosclerosis,it is the one of the causes of cerebral infarction.