血清Hcy水平对脑梗死患者复发与生存状况的影响

Effect of serum Hcy level on recurrence and survival status in patients with cerebral infarction

目的探讨血清同型半胱氨酸(Hcy)水平对脑梗死患者复发与生存状况的影响。方法选取2011年4月至2015年4月于该院接受治疗的116例脑梗死患者,对患者体内Hcy水平进行测定,根据Hcy水平将患者分为高Hcy组(Hcy>15μmol/L)与低Hcy组(Hcy≤15μmol/L),其中高Hcy组52例,低Hcy组64例;另选取同期在该院体检、经头颅CT或MRI检查的健康者116例作为健康对照组,对所有人员进行Hcy水平测定,采用美国国立卫生研究院卒中量表(NIHSS量表)评估脑梗死高Hcy组与低Hcy组神经功能受损情况;统计高Hcy组与低Hcy组脑梗死、脑出血、心绞痛、心肌梗死血管事件复发率,以及调查两组患者出院后不同时间的生存率。结果健康对照组血清Hcy水平为(10.67±3.88)μmol/L,明显低于低Hcy组和高Hcy组患者Hcy水平,低Hcy组患者NIHSS评分为(6.21±2.13)分,明显低于高Hcy组患者的(14.23±3.12)分,差异均有统计学意义(P<0.05)。低Hcy组血管事件复发率为17.18%,明显低于高Hcy组的55.76%,差异有统计学意义(P<0.05)。64例低Hcy组患者出院后1、2、3年的生存率分别为92.18%(59例)、89.06%(57例)、89.06%(57例),明显高于同期高Hcy组患者的生存率,差异均有统计学意义(P<0.05)。结论高水平血清Hcy的脑梗死患者神经损伤程度高,脑梗死、脑出血、心绞痛、心肌梗死血管事件复发率高,生存状况差。

Objective To explore the effect of serum homocysteine（Hcy）on the recurrence and survival status in the patients with cerebral infarction.Methods One hundred and sixteen cases of cerebral infarction in our hospital from April 2011 to April2015were selected.The Hcy level was determined.According to the Hcy level,the patients were divided into the high Hcy group（Hcy15μmol/L）and low Hcy group（Hcy≤15μmol/L）,including 52 cases in the high Hcy group and 64 cases in the low Hcy group;other contemporaneous 116 individuals undergoing the physical examination,head CT or MRI were selected as the healthy control group.The Hcy levels in all subjects were measured.The National Institutes of Health Stroke Scale（NIHSS score）was adopted to assess the nerve function damage situation in the high Hcy group and low Hcy group;the recurrence rate of vascular events such as cerebral infarction,cerebral hemorrhage,angina and myocardial infarction.The survival rate in different time after discharge from hospital was investigated in the two groups.Results The serum Hcy level in the healthy control group was（10.67±3.88）μmol/L,which was significantly lower than that in the low Hcy group and high Hcy group,the NIHSS score in the low Hcy group was（6.21±2.13）points,which were significantly lower than（14.23±3.12）points in the high Hcy group,the differences were statistically significant（P〈0.05）;the recurrence rate of vascular events in the low Hcy group was 17.18%,which was significantly lower than 55.76%in the high Hcy group,the difference was statistically significant（P〈0.05）.The 1-,2-,3-year survival rates in 64 cases of the low Hcy group were 92.18%（59cases）,89.06%（57cases）and 89.06%（57cases）respectively,which were significantly higher than those at the same period in the high Hcy group,the difference was statistically significant（P〈0.05）.Conclusion The patients with cerebral infarction and high serum Hcy level have high degree of nerve injury and high recurrence rate of vascular events such as cerebral infarction,cerebral hemorrhage,angina and myocardial infarction,and poor survival status.