血浆同型半胱氨酸水平对青年急性脑梗死预后的影响

目的探讨血浆同型半胱氨酸(Hcy)水平对青年急性脑梗死(ACI)预后的影响。方法108例青年ACl患者按发病<24 h时的Hcy水平分为正常Hcy组、高Hcy组,后者又分为干预治疗组和常规治疗组,3组均给予常规脑梗死治疗,干预治疗组在常规治疗基础上给予叶酸5 mg、维生素B_(12) 500μg每日3次,连用3个月。在发病<24 h(治疗前)及治疗1个月、3个月时采用免疫荧光法测定3组患者血浆Hcy水平,并进行美国国立卫生院卒中量表(NIHSS)和Barthel指数(BI)评分。结果治疗3个月时,干预治疗组血浆Hcy水平比治疗前以及常规治疗组明显降低(均P<0.01);正常Hcy组和干预治疗组NIHSS评分明显低于常规治疗组(均P<0.05),BI评分明显高于常规治疗组(均P<0.05)。结论血浆Hcy水平增高的青年ACI患者预后差,对高Hcy血症干预治疗可以改善青年ACI患者的预后。

Influence of plasma homocystine level on the prognosis of the young acute cerebral infarction patients

Objective To explore the influence of plasma homocystine （Hcy） level on the prognosis of the young acute cerebral infarction （ACI） patients. Methods The plasma Hcy levels of 108 young patients with ACI were measured by fluorometric method at time points of less than 24h （pre-treatment）, lmonth and 3 months after onset. The patients were divided into normal Hcy group and hyperhomocystinemia group, furthermore, the hyperhomocystinemia group were divided into interventional therapy group （administrating folic acid 5 mg and Vitamin B 12 0. 5 mg three times per day, 3 months） and conventional therapy group. At each time points, the plasma level of Hcy were measured, and the National Institute Health Stroke Scale （NIHSS） and Barthel Intex （BI） were evaluated. Results After 3 months treatment, the plasma Hcy level of the interventional therapy group was significantly lower than that of the conventional therapy group （ P 〈 0.01 ）. The scores of NIHSS were significantly lower and scores of BI were significantly higher in the normal Hcy group and interventional therapy group than those in the conventional therapy group （ P 〈 0. 05 ）. Conclusion The young ACI patients with hyperhomocystinemia may had worse prognosis than normal Hcy. The effectively interventional therapy of hyperhomocystinemia could improve the prognosis of the young ACI.