冠心病患者急性脑梗死后血清Hcy SIRT3水平与神经功能恢复的相关性

Correlation between serum Hcy and SIRT3 levels and neurological function recovery in patients with coronary heart disease after acute cerebral infarction

目的观察冠心病患者急性脑梗死(ACI)后血清同型半胱氨酸(Hcy)、沉默信息调节因子相关酶3(SIRT3)水平及神经功能恢复情况,分析Hcy、SIRT3水平与神经功能恢复的关系。方法选取2017-01—2019-12郑州市第九人民医院收治的58例冠心病并发ACI患者为研究对象,所有患者给予常规药物治疗,分别于治疗前后使用美国国立卫生研究院卒中量表(NIHSS)评估患者神经功能;检测患者血清Hcy、SIRT3水平;并根据NIHSS治疗前后减分率判定神经功能恢复效果并分组,分析冠心病患者ACI后血清Hcy、SIRT3水平与神经功能恢复的关系。结果冠心病并发ACI患者治疗后血清Hcy、SIRT3水平及NIHSS评分均较治疗前降低,差异有统计学意义(P<0.05);58例患者治疗后,恢复较优20例,恢复良好13例,恢复可15例,恢复差10例,神经功能恢复优良率为82.76%;神经功能恢复不良组治疗前后的血清Hcy、SIRT3水平均高于恢复良好组,差异有统计学意义(P<0.05);经回归分析结果显示,血清Hcy、SIRT3过表达是冠心病患者ACI后神经功能恢复不良的影响因素(OR>1,P<0.05);绘制ROC曲线结果显示,Hcy、SIRT3用于预测冠心病患者ACI后神经功能恢复不良风险的曲线下面积分别为0.801、0.873,均有一定预测价值。结论血清Hcy、SIRT3过表达可能提示冠心病患者ACI后神经功能恢复不良高风险,监测血清Hcy、SIRT3水平变化可为临床早期评估冠心病并发ACI患者神经功能恢复不良风险及干预计划的拟定提供参考。

Objective To observe the level of serum homocysteine(Hcy),silence information regulator related enzyme 3(SIRT3)and neurological function recovery after acute cerebral infarction(ACI)in patients with coronary heart disease,and to analyze the relationship between levels of Hcy,SIRT3 and neurological function recovery.Methods A total of 58 patients with coronary heart disease complicated with ACI who were admitted to our hospital from January 2017 to December 2019 were selected as the research subjects.All patients were given conventional drug treatment,and the National Institutes of Health Stroke Scale(NIHSS)was used before and after treatment.Assessed the neurological function of patients;tested the serum Hcy and SIRT3 levels of the patients;and determined the neurological recovery effect according to the decrement rate before and after NIHSS treatment and grouped them,and analyzed the relationship between the serum Hcy,SIRT3 levels and neurological recovery of coronary heart disease patients after ACI.Results Serum Hcy,SIRT3 levels and NIHSS scores of patients with coronary heart disease complicated with ACI were lower than before treatment,the difference was statistically significant(P<0.05);Among 58 patients after treatment,there were 20 cases of relatively great recovery,13 cases of good recovery,15 cases of general recovery,10 cases of poor recovery,the excellent rate of neurological recovery was 82.76%;The levels of serum Hcy and SIRT3 before and after treatment in the group with poor neurological recovery were higher than those in the group with good recovery,the difference was statistically significant(P<0.05);The results of regression analysis showed that the overexpression of serum Hcy and SIRT3 were the influencing factors of poor recovery of neurological function after ACI in patients with coronary heart disease(OR>1,P<0.05);the results of drawing the ROC curve showed that the areas under the curve used by Hcy and SIRT3 to predict the risk of poor neurological function recovery in patients with coronary heart disease were0.801 and 0.873,respectively,which had certain predictive value.Conclusion Overexpression of serum Hcy and SIRT3 may indicate a high risk of poor neurological function recovery in patients with coronary heart disease after ACI.Monitoring changes in serum Hcy and SIRT3 levels,it can provide a reference for the risk of adverse neurological recovery and the preparation of intervention plans on early clinical evaluation of patients with coronary heart disease complicated with ACI.