急性脑梗死患者Hcy、叶酸、维生素B_(12)水平与预后关系研究

Relationship between Hcy, folic acid and vitamin B_(12) levels and prognosis in patients with acute cerebral infarction

目的探究不同程度急性脑梗死(acute cerebral infarction,ACI)患者同型半胱氨酸(Hcy)、叶酸及维生素B_(12)水平,并探讨3者与ACI患者预后之间的关系。方法180例脑梗死患者根据梗死灶大小,按照Adama法分为腔隙性ACI组65例,小面积ACI组58例和大面积ACI组57例。比较各组患者Hcy、叶酸、维生素B_(12)水平、NIHSS及MRS评分,分析ACI患者Hcy、叶酸、维生素B_(12)水平与预后指标的相关性。结果各组脑梗死患者Hcy、叶酸、维生素B_(12)水平组间差异有统计学意义(F=15.83、56.64、7.75,P<0.05)。治疗2周后,各组脑梗死患者Hcy水平低于治疗前,叶酸及维生素B_(12)水平高于治疗前,差异均有统计学意义(P<0.05)。发病后30天,各组ACI患者NIHSS评分及MRS评分差异存在统计学意义(F=171.09、146.78,P<0.05)。ACI患者Hcy水平与NIHSS及MRS评分呈正相关(r=0.76、0.74,P<0.05),叶酸水平与NIHSS及MRS评分呈负相关(r=-0.49、-0.41,P<0.05)。结论ACI患者血清Hcy水平增高,维生素B_(12)及叶酸水平减低,不同梗死面积ACI患者的Hcy、叶酸及维生素B_(12)水平具有差异。ACI患者Hcy及叶酸水平与NIHSS及MRS预后指标显著相关。

Objective To explore the levels of homocysteine(Hcy),folic acid and vitamin B_(12)in patients with different degrees of acute cerebral infarction(ACI),and to explore the relationship between the three indicators and the prognosis of ACI patients.Methods A total of 180 patients with ACI were divided into lacunar ACI group(n=65),small area ACI group(n=58)and large area ACI group(n=57)according to the size of the infarction area by Adama method.The levels of Hcy,folic acid,vitamin B_(12),and the scores of NIHSS and MRS were compared in each group.The correlation between Hcy,folic acid,vitamin B_(12)and the prognostic indicators was analyzed.Results There were significant differences in the levels of Hcy,folic acid and vitamin B_(12)among each group(F=15.83,56.64,7.75;P<0.05).After two weeks of treatment,the Hcy level of ACI patients in all groups was lower than before,and the levels of folic acid and vitamin B_(12)were higher than before(P<0.05).There were significant differences in NIHSS score and MRS score among each group(F=171.09,146.78;P<0.05).The Hcy level of ACI patients was positively correlated with NIHSS and MRS scores(r=0.76,0.74;P<0.05).The folic acid level was negatively correlated with NIHSS and MRS scores(r=-0.49,-0.41;P<0.05).Conclusions The level of Hcy in serum of ACI patients increased,while the level of vitamin B12 and folic acid decreased.The levels of Hcy,folic acid and vitamin B_(12)in ACI patients with different infarction area were different.Hcy and folic acid levels were correlated with NIHSS and MRS in patients with ACI.