同型半胱氨酸在急性脑梗死患者中的表达及临床意义

Expression and clinical significance of homocysteine in patients with acute cerebral infarction

目的探究血浆同型半胱氨酸(Hcy)水平与急性脑梗死(ACI)的相关性。方法选取陕西省森工医院2018年1月至2020年1月收治的ACI患者及进行常规体检的健康者各100例,分别纳入观察组与对照组,比较两组血浆Hcy水平;比较不同美国国立卫生研究院卒中量表(NIHSS)评分、梗死灶面积患者血浆Hcy水平;同时根据Hcy水平分为高Hcy组(≥15μmol/L)与低Hcy组(<15μmol/L),比较两组预后;采用Pearson相关分析血浆Hcy水平与NIHSS评分、改良Rankin量表(mRS)评分的关系。结果观察组血浆Hcy水平为(16.74±2.90)μmol/L,明显高于对照组的(9.52±1.68)μmol/L,差异有统计学意义(P<0.05);血浆Hcy水平在神经缺损轻度、中度、重度患者中依次升高,差异有统计学意义(P<0.05);大梗死灶患者血浆Hcy水平明显高于中梗死灶患者、小梗死灶患者,差异有统计学意义(P<0.05);高Hcy组患者预后良好率为48.7%,明显低于低Hcy组的75.0%,差异有统计学意义(P<0.05);Pearson相关分析结果显示,血浆Hcy水平与NIHSS评分呈正相关(r=0.524,P<0.001),与mRS评分呈负相关(r=-0.226,P=0.023)。结论ACI患者血浆Hcy水平呈高表达,与病情严重程度、预后有关。

Objective To explore the correlation between plasma homocysteine(Hcy)level and acute cerebral infarction(ACI).Methods A total of 100 ACI patients admitted to Shaanxi Sengong Hospital from January 2018 to January 2020 and 100 healthy people who underwent physical examination were selected as observation group and control group,the plasma Hcy levels of each group were compared,the plasma Hcy levels of patients with different National Institutes of Health Stroke Scale(NIHSS)score and infarct size were compared.At the same time,the Hcy level was divided into high Hcy group(≥15μmol/L)and low Hcy group(<15μmol/L),and the prognosis status of the two groups were compared.The relationships between plasma Hcy level and NIHSS score,Modified Rankin Scale(mRS)score were analyzed by Pearson correlation.Results The plasma Hcy level in the observation group was(16.74±2.90)μmol/L,which was significantly higher than that in the control group[(9.52±1.68)μmol/L](P<0.05).Plasma Hcy level increased in mild,moderate and severe nerve defect patients in turn(P<0.05).The plasma Hcy level in large infarction patients was significantly higher than that in medium infarction patients and small infarction patients(P<0.05).The good prognosis rate of high Hcy group was 48.7%,which was significantly lower than that of low Hcy group(75.0%)(P<0.05).Pearson correlation showed that plasma Hcy level correlated positively with NIHSS score(r=0.524,P<0.001),and negatively correlated with mRS score(r=-0.226,P=0.023).Conclusion The high level of plasma Hcy in ACI patients relates to the severity and prognosis of the disease.