脑出血与同型半胱氨酸的临床相关性分析

Clinical Correlation Analysis on Homocysteine and Cerebral Hemorrhage

目的探讨血清同型半胱氨酸及凝血指标与脑出血的相关性及其临床意义。方法选择2010年1月-2014年12月在我院经头颅计算机断层扫描(computed tomography,CT)证实的脑出血的住院患者146例为脑出血组,同期在我院进行体检的健康人员158例为对照组,将两组患者按年龄分为青年组、中年组、年轻老年组、老老年组4个亚组。分析脑出血组同型半胱氨酸(homocysteine,Hcy)的异常检出率,并对Hcy与年龄进行直线相关性分析。比较以上各亚组间血清Hcy值、D-二聚体、凝血酶原时间、凝血酶原时间活动度(prothrombin time activity,PTA)、国际标准化比值、活化部分凝血酶原时间、纤维蛋白原(fibrinogen,Fbg)水平并进行Logistic回归分析。结果 (1)脑出血组血清Hcy水平增高104例(71.2%),男性患者增高明显(83.3%),与对照组比较差异具有显著性。(2)脑出血组Hcy、Fbg水平比对照组各亚组均显著增高;PTA水平在中年组以上增高,与同龄对照组比较差异具有显著性;D-二聚体水平在老老年组与同龄对照组比较显著增高。(3)Logistic回归分析结果显示,Hcy、D-二聚体和Fbg为脑出血的独立危险因素。结论 Hcy是脑出血的危险因素,因此,在脑出血的预防和治疗策略中亦应重视对高同型半胱氨酸血症的干预。

Objective To explore the clinic significance and the correlation between the serum homocystein（Hcy） and blood coagulation index in cerebral hemorrhage.Methods A total of 146 patients with cerebral hemorrhage receiving treatment in the hospital from 2010 to 2014 were selected as the study subjects and contemporaneous 158 healthy individuals of physical examination were taken as the control group. The patients in two groups were divided into the youth group, middle age group, elderly age group and the longevity group by age. The Hcy anomaly detection rate of cerebral hemorrhage group were analyzed, and the linear correlation analysis between homocysteine and age was also made. The values of serum Hcy, D-Dimer, prothrombin time（PT）, prothrombin time activity（PTA）, international standardization ratio（INR）, activated partial prothrombin time（APTT）, fibrinogen（Fbg） level of above mentioned subgroups were compared and performed with logistic regression analysis.Results（1）104 cases of cerebral hemorrhage group had increased Hcy with the abnormal rate of 71.2% while male patients increased more obviously with the abnormal rate 83.3%. Compared with the control group, there was a significant statistical difference.（2）The serum Hcy, Fbg levels in hemorrhage group were higher than those in the control group, and the difference was statistically significant. PTA value level increased in middle age group and elderly age group, which had significant difference with the control group. D-Dimer levels in the longevity group were obviously higher than those in the control group.（3）Logistic regression analysis showed that Hcy, D-Dimer, Fbgwere independent risk factors for cerebral hemorrhage.Conclusion Hcy is a risk factor for cerebral hemorrhage. Therefore, in the strategy of prevention and treatment for cerebral hemorrhage, more importance should be attached to the intervention of homocysteine levels.