血浆同型半胱氨酸水平与急性脑梗死的关系

目的:探讨血浆同型半胱氨酸(Hcy)与急性脑梗死的关系以及叶酸、VitB12干预的作用。方法:149例急性脑梗死患者(脑梗死组)和同期40例健康体检者(对照组)采用酶联免疫法测定血浆Hcy;其中脑梗死组筛选出高Hcy血症患者85例,再随机分为叶酸、VitB12治疗组43例及常规治疗组42例作对照研究,观察其干预效果。结果:脑梗死组血浆Hcy水平明显高于对照组,高Hcy在脑梗死患者所占比率显著高于对照组,差异有统计学意义(P<0.01);叶酸、VitB12干预后治疗组血浆Hcy水平较治疗前明显下降(P<0.01),干预组治疗效果优于常规治疗组(P<0.01)。结论:血浆Hcy升高是急性脑梗死患者的重要危险因素,叶酸、VitB12治疗可降低血浆Hcy水平,对预防和治疗脑梗死具有重要意义。

Plasma homocysteine level and acute cerebral infarction

Objective：To investigate the relationship between plasma homocysteine level and acute cerebral infarction by observing the effect of intervention with folacin and VitB12. Methods： Enzymatic cycling assay was used to measure the plasma homocysteine levels in 149 patients with acute cerebral infarction （ cerebral infarction group） and 40 healthy subjects（ control group）. By screening, 85 with hyperhomocysteinemia were randomly sub-divided into intervention group with folacin and VitB12 （ n = 43 ） and group of conventional therapy （ control, n = 42） for observing the effect of intervention. Results： The plasma homocysteine level of patients in the cerebral infarction group was much higher than that in the control group, and the percentage of hyperhomocysteinemia in cases of acute cerebral infarction was much greater as compared with the controls （ P 〈 0.01 ）. The plasma homocysteine level reduced greatly after the intervention with folacin and VitB12 in comparison with pre-treatment and the therapeutic effect was better in intervention group than the conventional therapy group（ P 〈 0.01 ）. Conclusion ： Increased plasma Hcy level is a higher risk factor of acute cerebral infarction. Intervention with folic acid and Vit B12 can reduce the plasma homocysteine level and plays a key role in prevention and treatment of this disease.