同型半胱氨酸水平与缺血性脑卒中患者神经缺损关系探讨

目的 :探讨血清同型半胱氨酸(Hcy)含量与缺血性脑卒中患者病情严重程度的关系。方法 :将580例缺血性脑卒中患者按照神经功能缺损程度(NIHSS)评分分为轻症组258例、中症组146例及重症组96例,比较三组患者Hcy含量及高同型半胱氨酸血症(HHcy)比例。对HHcy患者采取综合治疗措施10d后,比较治疗前后Hcy含量及美国国立卫生院神经功能缺损评分(NIHSS评分)结果。结果 :由轻症组、中症组至重症组,三组Hcy水平及HHcy患者占比逐渐上升,组间差异具有统计学意义(P<0.05);HHcy患者治疗10d后的NIHSS评分(9.83±6.17)及Hcy含量为(18.5±5.7)umol/L,显著低于治疗前的NIHSS评分(19.33±6.03)及Hcy的含量(37.2±5.8)umol/L,两组比较差异显著(P<0.01)。结论 :Hcy含量与缺血性脑卒中患者病情严重程度密切相关,高Hcy患者的神经缺损程度高,治疗HHcy有助于改善缺血性脑卒中患者预后。

Discuss the relationship between homocysteine levels in blood and severity of ischemic stroke

Object：To discuss the relationship between homocysteine levels in blood and severity of ischemic stroke.Method：We divide 580 cases of ischemic stroke patients in accordance with neurologic NIHSS score into mild group （258 cases）, medium group（146 cases） and severe group （188cases）. We compared the Hcy level and computed the proportion of the elevated plasma Hcy level in the three groups. After treating with comprehensive treatment lasting 10 days, the Hcy levels and NIHSS score of paitents with HHcy before and after treatment were compared.Result：The Hcy level and the rate of HHcy rase one by one in mild group, medium group and severe group,also P〈0.05, the differences were statistically significant. After treating with comprehensive treatment lasting 10 days, he Hcy levels and NIHSS score of paitents with HHcy are（18.5±5.7）umol/L and（9.83±6.17）,while they are（18.5±5.7）umol/L and（19.33±6.03）before treatment .The difference between two groups was signiifcant（P〈0.01）.Conclusion：The relationship between Hcy levels in blood and severity of ischemic stroke was closely related. The higher level of Hcy is, the severer state of illness is . After state of illness easing, the content fall down along with it. With the active treatment, the conditions of prognosis of paitents with HHcy can be better.