原发性高血压合并急性脑梗死患者血清同型半胱氨酸水平变化

目的探讨血清同型半胱氨酸水平与原发性高血压合并急性脑梗死的关系。方法选取急性脑梗死患者96例，其中单纯脑梗死患者42例（脑梗死组），原发性高血压合并脑梗死患者54例（高血压脑梗死组）；选取同期就诊的单纯原发性高血压患者48例（高血压组）及健康体检患者40例（对照组）。观察所有研究对象的血清Hcy水平及脑梗死组、高血压脑梗死组患者脑梗死情况。结果中度高血压患者的血清Hcy水平较轻度高血压患者明显升高（P〈0．05），而重度高血压患者血清Hcy水平较中度高血压患者明显升高（P〈0．05）；高血压组、脑梗死组、高血压脑梗死组患者血清Hcy水平均较对照组明显升高（P〈0．01）；高血压脑梗死组血清Hcy水平较高血压组、脑梗死组均明显升高（P〈0．05）；高血压脑梗死组患者大面积梗死、再发性梗死、多灶性梗死的发生率较脑梗死组明显增高（P〈0．05）。结论血清Hcy水平增高与原发性高血压合并脑梗死的发生存在一定的关系，且与患者脑梗死病变程度有关。常规检测患者血清Hcy水平对于原发性高血压合并急性脑梗死患者的预防、治疗、预后等具有萤要的临床价值。

The change of serum homocysteine level in patients with primary hypertension and acute cerebral infarction

Objective To study the relationship between serum homocysteine level and primary hypertension and acute cerebral infarction patients. Methods 96 acute cerebral infarction patients were selected,including 42 cases with pure cerebral infarction( cerebral infarction group) and 54 cases of primary hypertension and cerebral infarction patients( hypertension and cerebral infarction group) ;48 cases of pure primary hypertension were selected as hypertension group;40 healthy persons were selected as control group. To observe the serum Hcy level of all subjects and the cerebral infarction situation of cerebral infarction group, hypertension and cerebral infarction group. Results The serum Hcy level of moderate hypertension patients was higher than mild hypertension patients (P ＜ 0.05 ), and the serum Hcy level of severe hypertension patients was higher than moderate hypertension patients( P ＜0.05). The serum Hcy level of hypertension group, cerebral infarction group, hypertension and cerebral infarction group was higher than the control group(all P ＜0.01 ),and the serum Hcy level of hypertension and cerebral infarction group was higher than hypertension group,cerebral infarction group( P ＜ 0.05). The incidence of large area infarction, recurrent infarction,multifocal infarction of hypertension and cerebral infarction group were higher than cerebral infarction group( all P ＜ 0.05). Conclusion The increase of serum Hcy level had a certain relationship with hypertension complicated with cerebral infarction, and it was related to the severity of cerebral infarction. Conventional Hcy level detection of patients had important clinical value for prediction,treatment and prognosis of patients with primary hypertension and acute cerebral infarction.