缺血性脑卒中血清同型半胱氨酸、维生素B12及25-羟基维生素D3水平的临床研究

目的研究首发急性缺血性脑卒中(AIS)患者血清同型半胱氨酸(Hcy)、维生素B_(12)及25-羟基维生素D_3水平变化与神经功能缺损及预后相关性。方法收集我院2016年2月~2017年2月神经内科收治的急性缺血性脑卒中患者60例为卒中组,同期我院体检中心健康体检者50例为对照组。记录入院后、3个月及6个月后血清Hcy、维生素B_(12)及25-羟基维生素D_325(OH)D_3]水平,以及3个时间点的NIHSS评分、mRS评分及BI指数。分析血清指标变化与神经功能缺损及预后相关性。患者没有接受影响血清指标变化的治疗。结果卒中组入院NIHSS评分与同型半胱氨酸(r=0.312,P0.05)、维生素B_(12)(r=0.415,P0.01)、25-羟基维生素D_3(r=0.375,P0.01)水平密切相关。3个月和6个月时的BI及6个月的mRS与维生素B_(12)水平呈正相关。结论血清Hcy、维生素B_(12)及25-羟基维生素D_3水平与首发急性缺血性脑卒中的神经功能缺损程度密切相关,但血清维生素B_(12)水平提示更好的预后相关性。

Clinical study on serum homocysteine, vitamin B12 and 25-Hydroxyvitamin D3 levels in ischemic stroke

Objective To study the relationship between serum homocysteine(Hcy), vitamin B12 and 25-hydroxyvitamin D3 levels and neurological impairment, prognosis in patients with first acute ischemic stroke (AIS). Methods A total of 60 patients with acute ischemic stroke admitted in the Department of Neurology from February 2016 to February 2017 in our hospital were included in the stroke group. During the same period, 50 healthy people from the physical examination center of our hospital were included in the control group. Serum Hcy, vitamin B12, and 25-hydroxyvitamin D3 25(OH)D3] levels as well as NIHSS score, mRS score, and BI index were recorded after admission, at 3 months and 6 months after admission. The correlation of serum index changes and neurological deficits and prognosis was analyzed.The patient did not receive treatment that affected changes in serum markers. Results The NIHSS score in the stroke group was positively correlated with homocysteine levels(r=0.312, P<0.05), and was negatively correlated with vitamin B12 levels(r=0.415, P<0.01) and 25-hydroxyvitamin D3 levels(r=0.375, P<0.01). The BI at 3 months and 6 months, and mRS at 6 months were positively correlated with vitamin B12 levels. Conclusion Serum levels of Hcy, vitamin B12, and 25-hydroxyvitamin D3 are closely related to the degree of neurologic impairment in the first acute ischemic stroke, but serum vitamin B12 levels suggest a better prognosis.