急性脑梗死患者血清同型半胱氨酸与尿酸及血脂水平变化的临床意义

Clinical significance of serum homocysteine,uric acid and blood lipid levels in patients with acute cerebral infarction

目的探讨急性脑梗死患者血清同型半胱氨酸、尿酸及血脂水平变化的临床意义。方法回顾性分析2019年4月至2020年4月本院收治的80例急性脑梗死患者和于本院体检的80名体检者的临床资料,其中急性脑梗死患者作为实验组,体检者作为对照组。比较两组临床资料和血清同型半胱氨酸、血脂及尿酸水平。根据实验组短期预后情况分为预后不佳组(n=20)和预后良好组(n=60),采用多因素Logistic回归方程分析急性脑梗死患者短期预后不佳的危险因素。结果实验组血清同型半胱氨酸、总胆固醇、低密度脂蛋白及尿酸水平均高于对照组,高密度脂蛋白水平低于对照组(P<0.05)。单因素分析结果显示,预后不佳组和预后良好组年龄、血脂水平、尿酸水平及血清同型半胱氨酸水平比较差异有统计学意义(P<0.05)。多因素Logistic分析结果显示,年龄、高血脂、尿酸及血清同型半胱氨酸水平是急性脑梗死患者短期预后不佳的危险因素(OR>1,P<0.05)。结论年龄、血清同型半胱氨酸水平、血脂水平和尿酸水平与急性脑梗死发生发展密切相关,也是导致急性脑梗死预后不佳的危险因素。因此,临床需监测患者血清同型半胱氨酸、血脂和尿酸水平,及时采取预防措施,改善其短期预后,降低病死率。

Objective To explore the clinical significance of the changes of serum homocysteine,uric acid and blood lipid levels in patients with acute cerebral infarction.Methods The clinical data of 80 patients with acute cerebral infarction admitted to our hospital and 80 physical examiners who underwent physical examination in our hospital from April 2019 to April 2020 were analyzed retrospectively.The patients with acute cerebral infarction were used as the experimental group,and the physical examinations were used as the control group.The clinical data,and the levels of serum homocysteine,blood lipid and uric acid levels were compared between the two groups.According to the short-term prognosis of the experimental group,they were divided into poor prognosis group(n=20)and good prognosis group(n=60).The risk factors of poor short-term prognosis in patients with acute cerebral infarction were analyzed by Logistic regression equation.Results The levels of serum homocysteine,total cholesterol,low density lipoprotein and uric acid in the experimental group were higher than those in the control group,and the level of high density lipoprotein was lower than that in the control group(P<0.05).Univariate analysis of showed that there were significant differences in age,and the levels of blood lipid,uric acid and serum homocysteine between the poor prognosis group and good prognosis group(P<0.05).Multivariate Logistic analysis of showed that the age,and the levels of hyperlipidemia,uric acid and serum homocysteine level were risk factors for poor short-term prognosis in patients with acute cerebral infarction(OR>1,P<0.05).Conclusion Age,and the levels of serum homocysteine,blood lipid and uric acid levels are closely related to the occurrence and development of acute cerebral infarction,they are also risk factors leading to poor prognosis of acute cerebral infarction.Therefore,it is necessary to monitor the levels of serum homocysteine,blood lipid and uric acid,and take preventive measures in time to improve its short-term prognosis and reduce the mortality.