高同型半胱氨酸血症和再发脑梗死危险性关系的研究

Study on the relationship between hyperhomocysteinemia and risk of recurrent cerebral infarction

目的:探讨高同型半胱氨酸血症(hyperhomocysteinemia,Hhcy)和再发脑梗死危险性的关系。方法:根据血清同型半胱氨酸检测水平将142例急性脑梗死(acute cerebral infarction,ACI)患者分为Hhcy组(n=62)和非Hhcy组(n=80),均治疗并随访2年。统计两组ACI患者脑梗死复发率情况,采用Logistic回归分析Hhcy和脑梗死再发的相关性。结果:Hhcy组脑梗死再发率为30.19%,显著高于非Hhcy组的13.43%(χ~2=5.037,P<0.05);两组患者死亡率比较,差异无统计学意义(χ~2=2.240,P>0.05);Logistic回归分析显示:除高血压、糖尿病传统危险因素外,Hhcy也是ACI患者脑梗死再发的独立危险因素(OR=1.137,95%CI 1.075～1.238,P<0.01)。结论:Hhcy是再发脑梗死的独立危险因素,为完善ACI二级预防提供了重要指导。

Objective:To explore the relationship between hyperhomocysteinemia (Hhcy) and risk of recurrent cerebral infarction. Methods:142 patients with acute cerebral infarction (ACI) were divided into Hhcy group ( n =62) and non-Hhcy group ( n =80) according to the level of serum homocysteine (hcy) detection.All patients were treated and followed up for 2 years.The recurrence rate of cerebral infarction in ACI patients of the two groups was counted,and the correlation between Hhcy and recurrence of cerebral infarction was analyzed by logistic regression. Results:The recurrence rate of cerebral infarction in Hhcy group was 30.19%,which was significantly higher than 13.43% in non-Hhcy group (χ^2=5.037,P <0.05).There was no significant difference in mortality between the two groups (χ^2 =2.240,P >0.05).Logistic regression analysis showed that besides the traditional risk factors of hypertension and diabetes mellitus, Hhcy was also an independent risk factor for cerebral infarction recurrence in ACI patients ( OR =1.137,95% CI 1.075~1.238, P <0.01). Conclusion:Hhcy is an independent risk factor for recurrent cerebral infarction and provides important guidance for improving secondary prevention of ACI.