血浆同型半胱氨酸、血清碱性磷酸酶、D二聚体在高血压合并脑梗死患者中的表达及临床意义研究

Study on the Expression and Clinical Significance of Plasma Homocysteine, Serum Alkaline Phosphatase and D-dimer in Patients with Hypertension Complicated with Cerebral Infarction

目的观察高血压脑梗死患者血浆同型半胱氨酸(Hcy)与D-二聚体(D-D)、血清碱性磷酸酶(ALP)水平,并分析其临床意义。方法将郑州市第一人民医院2020年5月至2023年5月收治的64例高血压合并脑梗死患者作为研究对象,同期选取60例老年高血压与60例健康体检者进行对照观察,根据美国国立卫生院卒中量表(NIHSS)评分,将高血压合并脑梗死组分为高血压脑梗死轻型神经功能缺损组(高血压脑梗死A组)和高血压脑梗死中重型神经功能缺损组(高血压脑梗死B组)。比较各组Hcy、D-D、ALP水平差异;Pearson相关性分析高血压合并脑梗死组Hcy、D-D、ALP水平与NIHSS评分的相关性。结果三组Hcy、D-D、ALP水平存在差异,通过两两对比,高血压合并脑梗死组与单纯高血压组高于健康组,差异具有统计学意义(P<0.05);高血压合并脑梗死组三项指标水平最高,其次为单纯高血压组,差异具有统计学意义(P<0.05);进一步比较高血压合并脑梗死不同严重程度下的相关指标发现,高血压脑梗死B组的Hcy、D-D、ALP高于A组,差异具有统计学意义(P<0.05);Pearson相关分析结果显示,血清Hcy、D-D、ALP水平与高血压脑梗死患者入院NIHSS评分均呈正相关(r=0.700、0.852、0.724)。结论Hcy、D-D、ALP在老年高血压和高血压并脑梗死患者中均处于较高水平,且与患者神经功能缺损程度密切相关,三者联合检测之下对预测脑血管病变有一定的临床应用价值,对合理选择治疗方案,选择最佳术式有一定帮助。

Objective Observing the levels of plasma homocysteine(Hcy),D-dimer(D-D)and serum alkaline phosphatase(ALP)in hypertension patients with cerebral infarction,and analyzing their clinical significance.Methods A total of 64 patients with hypertension complicated with cerebral infarction admitted to the First People's Hospital of Zhengzhou from May 2020 to May 2023 were selected as the research subjects.During the same period,60 elderly patients with hypertension and 60 healthy examinees were selected for comparative observation.According to National institute of health stroke scale(NIHSS)scores,the hypertension patients with cerebral infarction were assigned to mild neurological deficit group(group A)and moderate and severe neurological deficit group(group B).Differences in Hcy,D-D,and ALP levels among different groups were compared.Pearson correlation coefficient was used to analyze the correlations of Hcy,D-D and ALP levels with NIHSS scores of hypertension patients with cerebral infarction.Results There were differences in the levels of Hcy,D-D,and ALP among the three groups.Through pairwise comparison,the hypertension combined with cerebral infarction group and the simple hypertension group were higher than the healthy group,and the difference was statistically(P<0.05);The three indicators were highest in the group of hypertension combined with cerebral infarction,followed by the group of simple hypertension,and the difference was statistically significant(P<0.05);Further comparison of relevant indicators under different severity levels of hypertension combined with cerebral infarction revealed that Hcy,D-D and ALP levels in group B were significantly higher than those of group A,and the differences were statistically significant(P<0.05);Pearson correlation coefficient indicated that serum Hcy,D-D and ALP levels were positively correlated with NIHSS scores in hypertension patients with cerebral infarction(r=0.700,0.852,0.724).Conclusion Hcy,D-D,and ALP are all at high levels in elderly hypertensive and hypertensive patients with cerebral infarction,and are closely related to the degree of neurological deficits in patients,Therefore,Hcy,D-D and ALP combined examination is important to predict the cerebrovascular diseases,providing basis on the selection of rational treatment schemes and surgical modes.