摘要
目的:研究同型半胱氨酸和脑梗死、短暂性脑缺血发作(TIA)及脑出血的关系。方法 对450例脑卒中(包括短暂性脑缺血发作、脑梗死、脑出血)患者及149例对照组进行血清同型半胱氨酸(Hcy)水平的测定,经颅超声多普勒(TCD)检测颅内外血管。结果 发现脑梗死、TIA组和脑出血组血浆Hcy水平(分别为20.82±11.86,20.61±13.73,24.78±12.75umol/L)非常显著高于对照组(9.84±2.25umol/L,p<0.01);脑梗死组与脑出血组HCY水平有显著差异,P=0.041,高同型半脱氨酸血症在脑出血组的比例(75.5％)明显高于脑梗死组(56.5％)和TIA组(48.6％),p<0.05,高同型半胱氨酸血症对脑梗死、TIA、脑出血的相对危险度分别为1.670(95％的可信区间为1.089,2.562)、1.654(95％的可信区间0.828,3.302)、2.454(95％的可信区间1.479,4.071)。未发现缺血性脑卒中血管狭窄与高同型半胱氨酸血症比例间的统计学上的显著差异。病例组中有糖尿病的患者HCY的水平16.14±7.82(umol/l)明显低于无糖尿病者22.55±12.66(umol/L),p<0.01。结论 血浆Hcy水平不但与缺血性脑卒中有关,而且对脑出血也有显著影响,高同型半胱氨酸血症与脑出血的关系更密切。血管狭窄和同型半胱氨酸水平及比例间无显著差异,无糖尿病的脑卒中患者中,同型半胱氨酸水平对脑卒中有重要影响?
Objective To evaluale the level of Hcy in subtype of cerebral ischemic disorders and cerebral hemorhage and to observe the correlative factors. Methods A case - control study, were perfomed 450 cases with acute cerebral infarction (CD or transient ischemic attacks (TIA) or cerebral hemorrhage (CH) Were enrolled. 149 cases were used as control. All the subjects underwent transcranial Doppler and plasma Hey examination. Results Mean plasma Hcy were significantly higher in the all three groups (Group CI 20. 82 ± 11. 86 umol/L, Group TIA 20. 61 ± 13. 73 u-mol/L and Group CH 24. 78±12. 75 umol/L), comparing with normal control (9. 84 ± 2. 55 umol/L, P<0. 01). The Mean plasma Hcy were higher in the group of CI patients than in the group of CH patients ( P = 0. 041). The ratio of hyperhomocysteine in CH 75. 5%)is significantly higher than in CI (56. 5%) and TIA (48. 6%), P<0. 05. The Odds ratio of CI, TIA and CH of hyperhomocysteine was 1. 670 (95% CI,1. 089-2. 562), 1. 654(95%CI 0. 828-3. 302), 2. 454 (95%CI, 1. 479 - 4. 071). There was no significant difference between cerebral vascular stenosis and hyperhomocysteine in patients with ischemic stroke. The level of Hcy in the patients with coexisting diabetes (16. 14 ± 7. 82 umol/ 1) was significantly lower than that in the patients with no diabetes (22. 55 ± 12. 66 umol/l), P<0. 01. Conclusion There is a significantly association between hyperhomocystinemia and ischemic cerebrovascular disease or CH. The frequency of hy perhomocysteine in CH is higher than in Cl and TIA. CH is significantly correlated with increased Hcy. The correlation of cerebral vascular stenosis and the level of Hcy is not found in this study. The level of Hcy has an important influence on stroke in the patients of cerebral stroke with no diabetes.
出处
《脑与神经疾病杂志》
2003年第5期281-284,共4页
Journal of Brain and Nervous Diseases
