血清同型半胱氨酸和纤维蛋白原与急性脑卒中的相关性研究

摘要

目的 研究血清同型半胱氨酸和纤维蛋白原与急性脑卒中的相关性,并初步探讨两者在急性脑卒中的作用机制.方法 选取116例急性脑卒中患者,根据NIHSS进行评分后分为轻型脑卒中组(38例)、中型脑卒中组(46例)和重型脑卒中组(32例),并设50例健康对照组.统计分析所有人组者一般情况(包括性别、年龄、吸烟饮酒史、高血压、糖尿病病史等情况),检测血糖、血脂Hcy以及FIB等.对急性脑卒中的多重危险因素采用Logistic分析.结果 ①各组间Hcy和FIB水平存在显著性差异(F-21.56,P＜0.05),遂进一步采用LSD进行两两分析,健康对照组、轻、中、重型脑卒中组的Hcy和FIB水平呈进行性升高,差异具有统计学意义;②高血压史、糖尿病史、Hcy以及FIB为急性脑卒中的独立危险因素;③Hcy水平与FIB、年龄、糖尿病病程以及高血压病程呈正相关(P＜0.05),与空腹血糖、收缩压、LDL-c水平无相关性(P＞0.05);FIB水平与Hey、糖尿病病史以及空腹血糖呈正相关,(P＜0.05),与年龄、收缩压、LDL-c水平无相关性(P＞0.05).结论 清同型半胱氨酸和纤维蛋白原与急性脑卒中关系密切,且均为急性脑卒中的独立危险因素.%Objective To study the correlation between serum homocysteine,fibrinogen and acute stroke;to investigate the action mechanism of the two factors on acute stroke.Methods 116 patients with acute stroke were divided into three groups according to NIHSS score:mild stroke group (n =38),moderate stroke group (n =46),severe stroke group (n =32).There was also a control group with normal subjects (n =50).Basic information (including gender,age,smoking and drinking history,hypertension history and diabetes history,etc.),the level of blood glucose,blood lipid and FIB of all the patients and normal subjects were collected or detected.Logistic analysis was applied to manage multiple risk factors in acute stroke.Results ①Significant differences in level of Hcy and FIB can be seen among groups(F =21.56,P＜0.05).According to further contrastive analysis with LSD,the level of Hcy and FIB among the control group,mild stroke group,moderate stroke group and severe stroke group increased gradually,with statistical significance.②)Hyperrension history,diabetes history,Hcy and FIB are independent risk factors of acute stroke.③Positive correlation was found between the level of Hcy and FIB,age,diabetes history,hypertension history(P＜0.05),while no correlation with fasting blood glucose,systolic pressure and the level of LDL-s (P＞0.05).Positive correlation was also found between the level of FIB and Hcy,diabetes history,fasting blood glucose(P＜0.05),while no correlation with age,systolicpressure and the level of LDL-s (P＞0.05).Conclusion Serum homocysteine and fibrinogen are closely linked with acute stroke.The two factors are also independent risk factors of acute stroke.