360例脑卒中患者高同型半胱氨酸血症发生率及相关因素分析

摘要

目的 调查360例脑卒中住院患者高同型半胱氨酸(Hcy)血症的发生率及其意义.方法 选择2010年8月至2011年6月神经内科住院的患者为研究对象,共收集有效病例360例,脑梗死组260例,脑出血组100例,另选同期住院非脑卒中患者200例为对照组,测定各组Hcy、GLU、TG、CHOL、HDL、LDL-C、FIB的水平.结果 脑梗死组和脑出血组的Hcy含量分别为(19.08±10.33)umol/L、(18.76±10.23)umol/L,与对照组相比显著升高(P<0.01).脑卒中组的血浆FIB含量与对照组相比差异亦具有统计学意义(P<0.01).但脑卒中组GLU、TG、CHOL、HDL、LDL-C水平与对照组比较,差异无统计学意义(P>0.05).脑梗死组和脑出血组高同型半胱氨酸血症发生率均高于对照组(P<0.01).结论 高同型半胱氨酸血症是脑卒中的独立危险因素,高同型半胱氨酸致血浆纤维蛋白原升高,是造成脑梗死患者血液黏度升高的主要原因.%Objective To investigate the incidence rate of hyperhomocysteinemia ( Hey ) in the 360 inpatients with stroke and the clinical significance as well. Methods Patients with stroke in the neurologic department of our hospital from Aug. , 2010 to June, 2011 were chosen as the research objects. Among the 360 cases in effect, 260 cases were the cerebral infarction group and 100 cases the cerebral hemorrhage group; besides 200 contemporary non - stroke patients in the neurologic department were chosen as the control group. The levels of Hey, GLU, TG, CHOL,HDL, LDL -C and FIB of the three groups were respectively detected. Results Hey contents of the cerebral infarction group and the cerebral hemorrhage group were respectively 19. 08 ± 10. 33umol/L, 18. 76 ± 10. 23umol/L,obviously higher than the control group, which was of statistical significance ( P <0. 01 ). FBI contents of the former two groups, evidently higher than contents of the control group, which was also of statistical significance ( P <0. 01 ). However, in terms of levels of GLU, TG, CHOL,HDL, LDL - C, the difference between the former two groups and the control group was of no statistical significance ( P > 0. 05 ). The incidence rates of hyperhomocysteinemia in the cerebral infarction group and the cerebral hemorrhage group were both higher than that in the control group, which was of statistical significance ( P <0. 01 ). Conclusion Hyperhomocysteinemia is an independent risk factor in the stroke and that homocysteine contributes to the increase of the plasma fibrinogen is a primary cause for the upgrading of blood viscosity of cerebral infarct.