血清高半胱氨酸水平与急性缺血性卒中严重程度的相关性

Correlation between serum homocysteine level and severity of acute ischemic stroke

目的 探讨血清高半胱氨酸（homocysteine,Hcy）水平与急性缺血性卒中（acute ischemic stroke,AIS）严重程度的相关性.方法 回顾性收集AIS患者的临床资料,利用美国国立卫生研究院卒中量表评分评估卒中严重程度,≤8分定义为轻度卒中,〉8分定义为中重度卒中.比较两组基线临床资料和血液检测指标,多变量logistic回归分析确定AIS患者卒中严重程度的独立影响因素.结果 共纳入73例AIS患者,男性42例（57.5％）,年龄18～77岁.轻度卒中组39例（53.4％）,中重度卒中组34例（46.6％）.单变量分析显示,中重度卒中组Hcy和高密度脂蛋白胆固醇水平以及高血压和高同种半胱胺酸血症患者比例显著高于轻度卒中组（P均〈0.05）.多变量logistic回归分析显示,高血压[优势比（odds ratio,OR）5.529,95％可信区间（confidence interval,CI）2.730～11.196;P〈0.001]和Hcy（OR 1.682,95％CI 1.114～2.538;P=0.013）是AIS患者卒中严重程度的独立影响因素.结论 AIS患者血清Hcy水平与卒中严重程度密切相关.

Objective To investigate the correlation between serum homocysteine（Hcy）and severity of acute ischemic stroke（AIS）.Methods The clinical data of patients with AIS were collected retrospectively. The National Institutes of Health Stroke Scale （NIHSS） scores were used to evaluate the severity of stroke. The NIHSS score≤8 was defined as mild stroke and 〉8 was defined as moderate to severe stroke. The baseline clinical data and blood test indices between the 2 groups were compared. Multivariable logistic regression analysis was used to identify the independent factors of severity in patients with AIS. Results A total of 73 patients with AIS were enrolled,including 42 males（57.5%）.Their age ranged from 18 to 77 years. There were 39 patients （53.4%） in the mild stroke group and 34 （46.6%） in the moderate to severe stroke group.Univariate analysis showed that Hcy and high-density lipoprotein cholesterol level and the proportions of patients with hypertension and hyperhomocysteinemia in the moderate to severe stroke group were significantly higher than those in the mild stroke group（all P〈0.05）. Multivariate logistic regression analysis showed that hypertension（odds ratio[OR]5.529, 95% confidence interval[CI]2.730-11.196; P〈0.001） and Hcy （OR 1.682,95% CI 1.114-2.538;P=0.013）were the independent influencing factors of the severity of stroke in patients with AIS. Conclusion The serum Hcy level in patients with AIS was closely associated with the severity of stroke.