老年脑卒中患者血清同型半胱氨酸水平r与神经功能缺损程度及预后的关系

摘要

目的 探讨老年脑卒中患者血清同型半胱氨酸(HCY)水平与神经功能缺损程度及预后的关系.方法 选择2014年1月至2015年12月在我院神经内科治疗的老年脑卒中患者148例为病例组,其中出血性脑卒中36例,缺血性脑卒中112例;选择同期在我院行健康体检的老年人72例为健康对照组.测定所有受检者的血清HCY水平,分析HCY与神经功能缺损程度相关性,并比较不同HCY水平与不良心脑血管事件复发的关系.结果 148例患者中,轻度、中度及重度神经功能缺损分别为69例、52例与27例.出血性脑卒中组和缺血性脑卒中组患者的HCY水平分别为(23.28±7.24)μmol/L和(22.34±8.46)μmol/L,均高于健康对照组的(11.26±4.57)μmol/L,差异有统计学意义(F=25.32,P<0.05);重度、中度及轻度神经功能缺损组患者的HCY水平分别为(43.02±10.36)μmol/L、(29.12±10.21)μmol/L和(18.82±9.35)μmol/L,差异有统计学意义(F=32.51,P<0.05);HCY水平等级与神经功能缺损程度呈正相关(r=0.72,P<0.01);HCY(+++)组不良心脑血管事件的复发率为37.78%,明显高于HCY(++)组的20.41%和HCY(+)组的9.26%,差异均有统计学意义(P<0.05).结论 血清HCY水平与老年脑卒中的发生关系密切,其不仅能反映患者的疾病严重程度,而且有助于评估脑卒中预后.%Objective To probe relationship of serum homocysteine (HCY) with the degree of nervous func-tional defect and prognosis in the elderly patients with stroke. Methods A total of 148 elderly patients with stroke, in-cluding 36 hemorhagic stroke (hemorrhagic stroke group) and 112 ischemia stroke (ischemic stroke group) in Depart-ment of Neurology of this hospital from Jan. 2014 to Dec. 2015 were chosen, and 72 healthy elders who accepted health examination at corresponding period in this hospital were chosen as healthy controls. The serum HCY were detected for all subjects, and the correlation of HCY with degree of nervous functional defect and the relationship of HCY with recur-rence of adverse cardiocerebral vascular events were analyzed. Results Within 148 stoke patients, the number of pa-tients with mild, medium and severe nervous functional defect were 69, 52 and 27 respectively. HCY in hemorrhagic stroke group and in ischemic stroke group were (23.28±7.24)μmol/L and (22.34±8.46)μmol/L respectively, which were higher than that in healthy controls (11.26 ± 4.57) μmol/L, with statistically significant differences (F=25.32, P<0.05). HCY in severe, medium and mild nervous functional defect group were (43.02 ± 10.36)μmol/L, (29.12 ± 10.21)μmol/L and (18.82±9.35)μmol/L, with statistically significant differences (F=32.51, P<0.05). The degree of HCY level was posi-tively correlated with degree of nervous functional defect (r=0.72, P<0.01). The recurrence rate of adverse cardiocerebral vascular events in HCY (+++) group was 37.78%, which was significantly higher than those of HCY (++) group (20.41%) and HCY (+) group (9.26%), and both of differences were statistically significant (P<0.05). Conclusion The serum HCY has close relationship with occurrence of stroke in elders, which can reflect the severity of illness and is ben-eficial to assess the prognosis of patients.