高同型半胱氨酸血症与脑梗死复发的关系

目的探讨高同型半胱氨酸血症(Hhcy)与脑梗死复发的关系。方法按血浆同型半胱氨酸(Hcy)水平,将139例急性脑梗死患者分为Hhcy组(42例,血Hcy≥15μmol/L)和非Hhcy(NHhcy)组(97例,血Hcy<15μmol/L)。给予入组者抗血小板治疗,以及控制已知的脑血管病危险因素等治疗;随访5年,观察两组脑梗死复发率及死亡率,分析影响脑梗死复发的危险因素。结果 Hhcy组脑梗死复发率(38.1%)和死亡率(19.0%)明显高于NHhcy组(15.5%,6.1%)(P<0.05～0.01)。Logistic回归分析显示,脑梗死复发与Hhcy(OR=1.110,95%CI:1.051～1.171,P<0.01)及糖尿病(OR=4.816,95%CI:1.693～13.697,P<0.01)有关。结论 Hhcy是脑梗死复发的独立危险因素之一。

Relationship between hyperhomocysteinemia and the recurrence of cerebral infarction

Objective To explore the relationship between hyperhomocysteine(Hhcy) and the recurrence of cerebral infarction(CI).Methods According to the level of plasma homocysteine(Hcy),139 acute CI patients were divided into Hhcy group(42 cases,Hcy≥15 μmol/L) and non-Hhcy(NHhcy) group(97 cases,Hcy<15 μmol/L).All of them received the treatment with antiplatelet and control risk factors of cerebrovascular disease.Then the recurrence rate of CI and the mortality of the 2 groups were observed by 5 years followed-up.The risk factors of CI recurrence were analyzed.Results The recurrence rate of CI and the mortality in Hhcy group(38.1%,19.0%) were significantly higher than that in NHhcy group(15.5%,6.1%)(P<0.05-0.01).Logistic analysis showed that the recurrence of CI was related with Hhcy(OR=1.110,95%CI: 1.051-1.171,P<0.01) and diabetes mellitus(OR=4.816,95%CI: 1.693-13.697,P<0.01).Conclusion Hhcy is one of the independent risk factors of CI recurrence.