急性脑梗死患者血管内皮功能及同型半胱氨酸水平的变化

Changes of vascular endothelial function and homocysteine level in patients with acute cerebral infarction

目的探讨急性脑梗死患者的治疗及其血管内皮功能、同型半胱氨酸水平变化。方法选择延安大学附属医院2015年8月至2016年12月收治的98例急性脑梗死患者为观察组,选择同期进行体检的98例健康者为对照组。对比2组患者血管内皮功能、Hcy水平及治疗前后各项指标的变化情况。结果治疗前观察组患者FMD、NO、eNOS水平显著低于对照组(t=-11.310、-7.669、-8.883,P<0.05),IMT、Hcy水平高于对照组(t=21.416、24.333,P<0.05)。治疗后,观察组患者Hcy水平显著下降(t=14.219,P<0.05),NO、eNOS水平升高(t=-9.859、-11.131,P<0.05);FMD水平无变化(t=-1.147,P>0.05);NIHSS评分下降,BI评分升高(t=10.954、-10.797,P<0.05)。结论 ACI患者血管内皮功能出现障碍,Hcy水平显著升高。叶酸及维生素B12临床疗效显著,可有效缓解血管内皮功能障碍,降低Hcy水平,改善患者预后。

Objective To investigate the changes in vascular endothelial function and homocysteine（Hcy）level and the treatment of patients with acute cerebral infarction（ACI）.Methods 98 patients admitted in our hospital from August 2015 to December 2016 were enrolled as the observation group,and 98 healthy people accepting health examination during the same period were selected as the control group.The vascular endothelial function and levels of Hcy,as well as the changes of indexes before and after treatment were compared between the two groups.Results Before treatment,the levels of FMD,NO and eNOS in the observation group were significantly lower than in the control group（t=-11.310,-7.669,-8.883respectively;P〈0.05）,while the levels of IMT and Hcy were significantly higher than in the control group（t=21.416,24.333respectively;P〈0.05）.After treatment,the level of Hcy decreased significantly（t=14.219,P〈0.05）while the levels of NO and eNOS increased in the observation group（t=-9.859,-11.131respectively;P〈0.05）.No change in FMD level was observed（t=-1.147,P〉0.05）.NIHSS score decreased while BI score increased（t=10.954,-10.797respectively;P〈0.05）.Conclusion ACI patients have vascular endothelial dysfunction,and their Hcy levels were significantly elevated;the two factors play a synergistic role.Folic acid and vitamin B12 have significant clinical efficacy on the disease,which can effectively alleviate the vascular endothelial dysfunction,reduce the level of Hcy,and improve prognosis.