老年脑梗死后病人继发脑出血与血清同型半胱氨酸及肿瘤坏死因子水平相关性分析

Correlation of homocysteine and TNF-αwith hemorrhagic transformation in the elderly patients with cerebral infarction

目的探讨老年脑梗死后出血性转化(hemorrhagic transformation,HT)病人血清Hcy、TNF-α水平变化及HT的危险因素。方法选取2017年11月至2019年2月我院收治的脑梗死病人116例作为研究对象,根据磁敏感加权成像(SWI)检查结果分为HT组和NHT组,比较2组病人血清Hcy及TNF-α水平;收集2组TOAST分型、梗死面积、吸烟史、高血糖、高血压、高血脂、房颤史及脑卒中史等资料,采用单因素及Logistic回归分析HT的危险因素。结果HT组病人血清Hcy及TNF-α水平均显著高于NHT组,差异有统计学意义(P<0.05);单因素分析结果表明,血清Hcy及TNF-α水平、TOAST分型、梗死面积、高血糖、高血压、房颤史与HT发生有关;多元Logistic回归分析结果表明,血清高Hcy及TNF-α水平、梗死面积大是HT发生的危险因素。结论老年脑梗死后HT病人血清Hcy、TNF-α水平及梗死面积与HT发生关系密切。

Objective To investigate the serum levels of homocysteine(Hcy)and tumor necrosis factor-α(TNF-α)and the risk factors of hemorrhagic transformation(HT)in the elderly patients with cerebral infarction.Methods A total of 116 patients with cerebral infarction admitted to our hospital from November 2017 to February 2019 were selected.The patients were divided into HT group and NHT group accouding to susceptibility-weighted imaging(SWI)examination.Serum levels of Hcy and TNF-αwere compared between the two groups.The data of TOAST types,infarct area,smoking history,hyperglycemia,hypertension,hyperlipidemia,atrial fibrillation history and stroke history was collected and analyzed by Logistic regression analysis.Results The serum levels of Hcy and TNF-αin HT group were significantly higher than those in NHT group(P<0.05).Logistic regression analysis showed that high serum levels of Hcy and TNF-α,larger infarct area were risk factors for HT.Conclusions The serum levels of Hcy and TNF-α,and the infarct area are closely related to the occurrence of HT.