急性缺血性中风治疗前后Hcy水平的变化及临床意义

Changes and Clinical Significance of Hcy in Patients with Acute Ischemic Stroke before and after Treatment

目的:探讨不同中医证型患者在治疗前后的临床神经功能缺损程度评分与Hcy之间关系,预测评估患者神经功能恢复情况,观察急性期缺血性脑卒中(中风)患者治疗前后血浆同型半胱氨酸(Hcy)的水平。方法:采用前瞻性对照研究方法,筛选40例符合标准的研究对象行一次性血样采集,测出其治疗前及治疗14 d后的血浆Hcy水平,并将研究对象按各种中医证型划分并进行神经功能缺损程度评分,衡量不同证型患者神经功能恢复的情况。结果:患者Hcy下降率与神经功能缺损程度评分下降率呈高度相关(r=0.705,P<0.01),风痰瘀阻型患者中,Hcy下降率与神经功能缺损程度评分下降率呈高度相关(r 0.859,P<0.01)。结论:中风患者Hcy下降率可作为治疗后神经功能恢复的参考指标,尤其对于风痰瘀阻型患者。

Objective： To explore the relationship between Hcy and clinical neurological deficit scores before and after treatment in patients with different syndromes of traditional Chinese medicine （ TCM ）, to predict the recovery of neurological function in patients with acute ischemic stroke （ stroke ） before and after treatment, the levels of plasma homocysteine （ Hcy ） levels.Method ： A prospective control study was conducted to screen 40 patients who met the standard of blood sampling and to measure plasma Hey levels before and 14 days after treatment.All subjects were divided into different TCM syndromes, the neurological function of patients with different syndromes were evaluated.Result： The rate of descent of Hcy was significantly correlated with the rate of neurological impairment （ r=0.705, P〈0.01 ） .The rate of descent of Hcy was significantly correlated with the decrease of neurological deficit score in patients with wind phlegm and stagnation （ r=0.859, P〈0.01 ） .Conclusion： The rate of Hcy decline in stroke patients can be used as a reference index for the recovery of neurological function after treatment, especially for patients with wind phlegm and blood stasis.