老年无症状性脑梗死与血浆同型半胱氨酸的关系

目的了解老年人群中无症状性脑梗死的患病状况,探讨血浆同型半胱氨酸(Hcy)与老年无症状性脑梗死的关系。方法164例住院体检的老年病人,通过询问病史、神经系统体格检查和头部MRI检查,将观察对象分为无症状性脑梗死组和对照组,记录血压、体质量指数(BMI)并检测血浆Hcy、维生素B12(VitB12)、叶酸、空腹血糖和血脂等。结果164例老年患者中48例有无症状性脑梗死,占29.3%。无症状性脑梗死组血浆Hcy水平较对照组明显升高(P<0.01),此外2组间的收缩压、BMI、叶酸和VitB12水平的差异有统计学意义(P<0.05)。血浆Hcy水平与叶酸和VitB12水平呈负相关(P<0.05),而与血压、血脂、血糖和BMI无显著相关。结论高Hcy血症也应视为无症状性脑梗死的一个重要危险因素,在老年人群中监测血浆Hcy水平有助于早期发现无症状性脑梗死,血浆Hcy水平的降低对减少无症状性脑梗死的风险以及防止其进展有重要意义,通过补充叶酸和VitB12或许能为脑血管病的预防和治疗提供一个新途径。

Relationship between the plasma homocysteine and senile asymptomatic cerebral infarction

Objective To observe the morbidity of asymptomatic cerebral infarction (ACI) in elderly population and to investigate the relationship between plasma homocysteine (Hcy) and senile ACI. Methods 164 elderly patients coming for physical examination were enrolled. According to the disease history, physical examination findings and cerebral MRI, the subjects were divided into two groups: ACI group and control group. The blood pressure, body mass index (BMI) and the level of plasma Hcy, VitB12, folic acid, fasting blood glucose, blood lipid were detected. Results In the 164 cases, 48 cases (29.3%) suffered from ACI. The plasma Hcy level of ACI group was significantly higher than that of the control group (P<0.01). In addition, there were significant differences in the systolic pressure, BMI, folic acid and VitB12 between ACI group and control group (P<0.05). There was a negative correlation between plasma Hcy and folic acid, VitB12(P<0.05), while there was no statistical correlation between plasma Hcy and blood pressure, blood lipid, blood glucose, BMI. Conclusions High plasma Hcy level should be regarded as an important risk factor of ACI. Monitoring plasma Hcy level in elderly people is helpful to discover ACI earlier. Decreasing plasma Hcy level is crucial to reduce the risk of ACI and to prevent its progress into clinical stroke. In addition, complementing folic acid and VitB12 may be a new means to prevent and treat cerebrovascular diseases.