急性脑梗死患者血浆同型半胱氨酸、叶酸、维生素B_(12)水平的测定及其临床意义

The detection of plasma homocysteine, folate and vitamin B_(12) levels in patients with acute cerebral infarction

目的 探讨血浆同型半胱氨酸(Hcy)在急性脑梗死发病过程中的临床意义以及与病情、伴发症、叶酸、维生素B_(12)之间的关系。方法 采用化学发光法测定急性脑梗死患者血浆Hcy、叶酸、维生素B_(12)水平,并与对照组进行比较。结果急性脑梗死组血浆Hcy水平明显高于对照组(P<0.001),叶酸明显低于对照组(P<0.001);重型患者血浆Hcy水平明显高于中型及轻型患者(P<0.01,0.01),叶酸明显低于中型及轻型患者(P<0.01,0.05);伴发高血压病的患者血浆Hcy水平明显高于非高血压病的患者(P<0.05);急性脑梗死组血浆Hcy与叶酸、维生素B_(12)呈负相关(P<0.01,0.01);对照组血浆Hcy与叶酸呈负相关(P<0.05)。结论高Hcy血症是脑梗死的一个新的重要危险因素;Hcy水平与病情密切相关,与叶酸、维生素B_(12)呈负相关。

Objective To investigate the significance and effects of plasma homocysteine (Hcy) in occurrence and development of actue cerebral infarction and the relationship among plasma Hcy levels and condition of patients, folate and vitamin B_(12). Methods The plasma levels of Hcy, folate and vitamin B_(12) were measured in patients with acute cerebral infarction by automated chemiluminescence system, and compared with healthy controls. Results In the patient groups, the plasma levels of Hcy increased significantly (P<0.001 ) and the folate levels decreased significantly (P<0.001) as compared with healthy controls. In severe patients, the Hcy levels increased significantly (P<0.01, 0.01) and the folate levels decreased significantly (P<0.01, 0.05) as compared with middle and mild types. The Hcy levels were significantly higher in the patients with hypertension than the patients without hypertension (P<0.05). The Hcy level was negatively correlated with folate and vitamin B_(12)(P<0.01, 0.01) in the patient group, and was negatively correlated with folate (P<0.05) in healthy controls. Conclusions Hyperhomocysteinemia may be a new and an important risk factor for acute cerebral infarction, the Hcy levels of plasma were correlated with degree of the disease, and were negatively correlated with the levels of folate and vitamin B_(12)。