脑梗死患者血清同型半胱氨酸、叶酸、维生素B12水平检测及其临床价值分析

目的：研究脑梗死患者血清同型半胱氨酸、叶酸、维生素B12水平及其临床价值。方法：将在本院接受治疗的脑梗死患者纳入研究的观察组,参照Pullicinp法选择轻度梗死、中度梗死和重度梗死患者各50例;将同期在本院接受体检的50例健康者纳入研究的对照组。检测受试者的血清同型半胱氨酸（Hcy）、叶酸、维生素B12、C反应蛋白（CRP）、肿瘤坏死因-a（TNF-a）水平。结果：轻度、中度和重度梗死患者的血清Hcy、CRP、TNF-a、基质金属蛋白酶-9（MMP-9）水平高于对照组,叶酸、维生素B12、神经营养因子（NTF）、神经生长因子（NGF）水平低于对照组,差异有统计学意义（P〈0.05）;血清同型半胱氨酸水平与CRP、TNF-a、MMP-9水平呈正相关,与NGF、NTF呈负相关;叶酸、维生素B12水平与CRP、TNF-a、MMP-9水平呈负相关,与NGF、NTF呈正相关。结论：急性脑梗死患者血清中同型半胱氨酸、叶酸、维生素B12水平发生改变,且与炎症因子含量以及神经细胞因子含量的变化密切相关,可作为评估病情的理想指标。

Serum homocysteine,folate,vitamin B12 levels in cerebral infarction patients

Objective： To study the serum levels of homocysteine, folate, vitamin B12 in patients of cerebral infarction. Methods： Cerebral infarction patients admitted from 2011 August to 2013 December were enrolled in observation group and 50 cases of mild infarction, moderate infarction and severe infarction were selected according to Pullicinp method; 50 healthy persons underwent physical examination were enrolled in control group. Then serum homocysteine, folate,vitamin B12 and C reaction protein, tumor necrosis factor-α content were detected. Results： Homocysteine, CRP TNF-α and MMP-9 content of mild, moderate and severe cerebral infarction patients were significantly higher than those of control group, folate, vitamin B12, NGF and NTF content of were significantly lower than control group（P〈0.05） homocysteine content was significantly positively correlated with CRP TNF-α and MMP-9 content, and negatively correlated with NGF and NTF content; folate and vitamin B12 content were negatively correlated CRP TNF-α and MMP-9 content, and positively correlated with NGF and NTF content. Conclusion： Patients of serum acute cerebral infarction have changes in homocysteine, folate, and vitamin B12 content. This disease is correlated to inflammatory factor and neural cytokine levels. These indexes can be used as ideal indexes for evaluation of disease.