脑梗死患者血清同型半胱氨酸、叶酸、维生素B12水平的测定及临床意义

目的 探讨血清同型半胱氨酸(Hcy)、叶酸(FA)及VitB12与脑梗死的关系及临床意义.方法 采用酶循环法和电化学发光免疫分析法分别检测100例脑梗死患者血清Hcy、FA及VitB12水平,并与同期60例健康体检者进行比较.结果 脑梗死组患者血清Hcy水平(16.35±5.52)μmol/L,升高比例(22％),明显高于对照组[(8.62±3.45)μmol/L,6.7％,P<0.01];血清FA和VitB12降低的脑梗死组患者升高比例(19％和24％)显著高于健康对照组(5.0％,11.7％,P<0.01),而血清FA水平(13.62±5.98)nmol/L和VitB12水平(527.35±288.65)pmol/L显著低于对照组[(18.45±6.70)nmol/L,(565.24±282.72)pmol/L,P<0.01].脑梗死组患者血清FA和VitB12水平与Hcy水平均呈负相关(r1=-0.365,r2=-0.625,P<0.05).结论 Hcy血症为脑梗死的高危因素,与FA和VitB12水平下降有关,Hcy、FA、VitB12的检测在脑梗死患者的预防与治疗中有重要的临床价值.

Analysis and clinical significance of serum homocysteine,folate, vitaminB12 in patients with cerebral infarclion

Objective To investigate the relationship of homocysteine(Hcy),VitB12 and folate(FA)with cerebral infarction to provide some theoretical basis in clinical practice.Methods The serum levels of Hcy,VitB12 and folate in the cerebral infarction group were detected by the enzymatic cycling method and chemiluminescence immunoassay respectively,their levels were compared with the results of the control group.Results The serum elevated proportion(22％)and levels of Hcy in the cerebral infarction group(16.35±5.52)μmol/L were significantly higher than the results in the normal control group[6.7％,(8.62±3.45)μmol/L,P<0.01].However the lower proportion of serum FA and VitB12 in the cerebral infarction group(19％,24％)were greater than the control(5.0％,11.7％,P<0.01).The secrum levels of FA and VitB12 in the cerebral infarction group [(13.62±5.98)nmol/L,(527.35±288.65)pmol/L] were lower than the results in the control group[(18.45±6.70)nmol/L,(565.24±282.72)pmol/L,P<0.01].Moreover,the levels of serum FA and VitB12 in the cerebral infarction group were negatively correlated with Hcy level(r1=-0.365,r2=-0.625,P<0.05).Conclusion High hyperhomocysteinemia is an independent risk factor of cerebral infarction and is related to the decrease of FA and VitB12.Detections of serum Hcy,FA,VitB12 could be of significant clinical valve in cerebral infarction.