急性缺血性脑卒中患者血浆同型半胱氨酸与B族维生素及凝血的相关性研究

Relationship of plasma Hcy with B vitamins and blood coagulation in AIS patients

目的探讨急性缺血性脑卒中患者血浆同型半胱氨酸(Hcy)与叶酸、维生素B_(12)、血浆纤维蛋白原(FIB)、凝血酶原时间(PT)、血小板计数、LDL、HDL的相关性。方法收集2020年1~6月解放军总医院第八医学中心神经内科收治的急性缺血性脑卒中患者50例,根据Hcy正常参考值分为高Hcy组30例和正常Hcy组18例,低Hcy仅2例未纳入分组。采集发病3 d内的血液化验指标,采用Pearson相关分析Hcy与观察指标的相关性。结果高Hcy组与正常Hcy组叶酸、FIB、PT、血小板计数、LDL、HDL水平比较,无统计学差异(P>0.05),高Hcy组维生素B_(12)水平明显低于正常Hcy组[(258.57±137.48)ng/L vs(340.33±122.29)ng/L,P=0.034]。Pearson相关分析显示,叶酸、FIB、血小板计数、LDL、HDL与Hcy无明显相关性(P>0.05)。维生素B_(12)与Hcy呈负相关(r=-0.424,P=0.002),PT与Hcy呈正相关(r=0.379,P=0.007)。结论急性缺血性脑卒中患者血浆Hcy水平与维生素B_(12)、PT有相关性,与脂质代谢无明显相关性,Hcy水平升高可能会影响凝血机制的变化。

Objective To study the relationship of plasma Hcy with folic acid, vitamin B_(12),serum fibrinogen(FIB),LDL and HDL,prothrombin time(PT),platelet count in acute ischemic stroke(AIS) patients.Methods Forty-eight AIS patients admitted to Chinese PLA General Hospital No.8 Medical Center from January 2020 to June 2020 were divided into high Hcy group(n=30) and normal Hcy group(n=18).Two patients with low Hcy were not inclued.The laboratory testing parameters within 3 days after onset of AIS were recorded.The association between plasma Hcy and laboratory testing parameters was analyzed by Pearson correlation analysis.Results No significant difference was detected in serum levels of folic acid, FIB,LDL and HDL,PT,platelet count between the two groups(P>0.05).The serum level of vitamin B_(12)was significantly lower in high Hcy group than in normal Hcy group(258.57±137.48 ng/L vs 340.33±122.29 ng/L,P=0.034).Folic acid, FIB,platelet count, LDL,HDL were not significantly associated with Hcy in AIS patients(P>0.05).Vitamin B_(12)was negatively associated with Hcy while PT was positively associated with Hcy in AIS patients(r=-0.424,P=0.002;r=0.379,P=0.007).Conclusion Plasma Hcy is associated with vitamin B_(12)and PT but not with the metabolism of blood lipids and is thus an influencing factor of coagulation mechanism in AIS patients.