高同型半胱氨酸血症与卒中的关系

目的 探讨高同型半胱氨酸（Homocysteine，Hcy）血症与卒中的关系。方法 选择卒中患者102例（66例脑梗死和36例脑出血）为卒中组，与病例组年龄、性别、种族等相匹配的未患过卒中来院进行健康体检者102例为对照组。采用高效液相色谱荧光检测法测定两组的血清Hcy水平。同时检测叶酸、维生素B12、血糖、血脂等。结果 卒中组血清Hcy水平显著高于对照组（20±9μmol/L?vs?9±6μmol/L，P<0.01）；脑梗死和脑出血患者的血清Hcy水平无统计学差异（P>0.05）；血清叶酸及维生素B12水平与血清Hcy均呈负相关；Logistic回归分析显示，高Hcy血症卒中的独立危险因素（OR?4.875，95%CI?1.902～8.552，P<0.05）。结论 高Hcy血症是卒中的独立危险因素；叶酸和VitB12的缺乏可能是导致高Hcy血症的原因之一。

The Relationship Between Hyperhomocysteinemia and Stroke

Objective To investigate the relationship between heperhomocysteinemia (Hcy) and stroke.Methods 102 patients with stroke (66 with cerebral infarction and 36 with cerebral hemorrhage) were included as the case group, while 102 subjects without stroke matched with the case group on gender, age and race were selected as control group. Hcy were measured by high-performance liquid chromatography and fluorescence detection. Levels of folate, Vitamin B12, blood glucose and Plasma lipid were measured as well.Results Plasma level of Hcy in case group was significantly higher than that in control group(20±9)μmol/L vs (9±6)μmol/L, P<0.01], but it showed no significant difference between patients with cerebral infarction and patients with cerebral hemorrhage(P>0.05). Significant negative correlation were observed between plasma level of Hcy and plasma level of folate, as well as vitamin B12. Based on Logistic regression model, the odds ratio(OR) of hyperhomocysteinemia was 4.875 (95%CI 1.902-8.552) for stroke.Conclusion Hyperhomocysteinemia is an independent risk factor for strok. Deficiency of plasma folate and vitamin B12 may be one of reasons of hyperhomocysteinemia.