青壮年缺血性脑血管病血清同型半胱氨酸水平的研究

Study on serum homocysteine level in the young patients with ischemic cerebrovascular disease

目的 探讨血清同型半胱氨酸 (Hcy)水平与缺血性脑血管病的关系。方法 研究对象为青壮年缺血性脑血管病患者 182例 ,分为 3组 :短暂性脑缺血发作 (49例 )、脑梗死急性期 (74例 )和脑梗死恢复期 (5 9例 ) ,正常对照组 38例。应用高效液相色谱法 ,测定空腹血清同型半胱氨酸浓度 ,应用自动生化分析仪测定血糖、血脂 ;同时对脑梗死急性期患者进行病灶体积计算。采用 SPSS软件分析。结果 脑梗死急性期血清同型半胱氨酸水平显著高于脑梗死恢复期及短暂性脑缺血发作组 (P<0 .0 1) ;3组均明显高于对照组 (P<0 .0 5～ 0 .0 1) ;血清 Hcy水平与病灶体积大小呈正相关 (r=0 .4 5 ,P<0 .0 5 ) ;高血压、糖尿病和高脂血症病史与血清 Hcy水平无明显的相关。结论 高 Hcy血症可能为青壮年缺血性脑血管病发病的独立危险因素 ,且血清同型半胱氨酸水平能反映脑梗死急性期病灶的大小。

Objective To study the relationship between serum homocysteine(Hcy) level and ischemic cerebrovascular disease among young adults. Methods The samples in this study were 182 young patients with ischemic cerebrovascular disease and 38 normal controls during a period of 14 months. 182 patients were divided into three groups. They were transient ischemic attack(49 cases),acute(74 cases) and convalescence(59 cases) phase of cerebral infarction. Fast serum Hcy concentration was measured by high-performance liquid chromatography method. Every patient took laboratory examinations,including fast plasma glucose,cholesterol and triglyceride. The volumes of infarction in acute phase group were calculated. The SPSS system was applied to analyze the data. Results Serum Hcy level was markedly higher in acute phase of cerebral infarction group than in other two groups( P < 0.01 ). Three groups were markedly higher than control group( P < 0.05 ～ 0.01 ). We found positive correlation between volume of focus and serum Hcy level( r =0.45, P < 0.05 ). Conclusion High-Hcy is a possible independent rise factor for ischemic cerebrovascular disease in young adult. Serum Hcy level can reflect the size of focus in acute phase of cerebral infarction.