急性缺血性脑卒中患者Hcy水平与神经功能缺损的相关性研究

Correlation between Hcy level and neurological impairment in patient with acute ischemic stroke

目的探讨急性缺血性脑卒中患者同型半胱氨酸((homocysteine,Hcy)水平与神经功能缺损的相关性。方法选取急性缺血性脑卒中患者80例,采用美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评估患者的神经功能损伤程度,NIHSS评分<8分为神经功能缺损轻症组40例,≥8分为神经功能缺损重症组40例,同时选取健康体检并符合筛选条件者40例为正常对照组,检测3组人员的空腹血糖(fasting blood-glucose,FBG)、尿酸、总胆固醇(total cholesterol,TC)、三酰甘油(triglyceride,TG)、低密度脂蛋白胆固醇(low density lipoprotein cholesterin,LDL-C)、高密度脂蛋白胆固醇、(high density lipoprotein cholesterol,HDLC)、纤维蛋白原(fibrinogen,Fg)、同型半胱氨酸(homocysteine,Hcy)水平,分析Hcy水平与NIHSS评分的相关性。结果神经功能缺损重症组FBG高于神经功能缺损轻症组和正常对照组,神经功能缺损轻症组高于正常对照组,神经功能缺损重症组TG高于正常对照组,差异均有统计学意义(P<0.05)。3组TC、LDL-C、HDL-C和脂蛋白差异无统计学意义(P>0.05)。急性缺血性脑卒中患者血浆Hcy水平显著高于正常对照组,且神经功能缺损重症组高于神经功能缺损轻症组,差异有统计学意义(P<0.05)。急性缺血性脑卒中患者的高Hcy血症例数显著多于对照组,且神经功能缺损重症组多于神经功能缺损轻症组,差异有统计学意义(P<0.05)。以血浆Hcy水平为变量,直线相关分析显示,急性缺血性脑卒中患者血浆Hcy水平与NIHSS评分呈显著正相关(P<0.05)。结论急性缺血性脑卒中患者血浆Hcy水平与神经功能缺损呈显著正相关,检测Hcy水平可为评估患者病情和预后提供参考价值。

Objective To determine the relationship between plasma homocysteine （ Hey）level and neurological impairment in patient with acute ischemic stroke. Methods acute ischemic stroke disease were chosen as the research object. At the time of admission, the National Institute of Health Stroke Scale（NIHSS） was employed to divided the patients into the mild group（NIHSS score〈8 scores） and the severe group（NIHSS score〉 8 scores）,each group with 40 cases. And 40 healthy persons were selected as control group. The fasting blood-glucose （FBG）,uric acid,total cholesterol （TC）, triglyceride （T G ）,low density lipoprotein cholesterin （LDL-C）,high density lipoprotein cholesterol（HDL-C）,fibrinogen, Hey levels of three groups were detected,and the correlation of Hey levels and NIHSS score were analyzed. Results TheFBG of severe group was higher than mild group and control group,the TG of severe group whigher than control group,and mild group. The difference has statistical significance（P 〈0. 05）.There was no statistically significant difference for TC, LDL-C , HDL-C and lipoprotein in three groups（P 〉0. 05）. The plasma Hey levels of severe group and mild group was significantly higher than the control group, and severe group was higher than mild group. The difference was statistically significant（P〈0. 05）. The high Hey number of patients with acute ischemic stroke was significantly higher than the control group, and severe group was higher than mild group. The difference was statistically significant （ P 〈 0. 05 ）. There was a significantly positivecorrelation between Hey levels and NIHSS score（ P 〈0. 05）. Conclusion The levels Hey and neurological impairment are significantly correlated. Detection of Hey levels may provide a reference value for evaluating the patient＇s condition and prognosis.