摘要
目的探讨急性脑梗死患者入院前后血清同型半胱氨酸(homocysteine,Hcy)与尿酸(uric acid,UA)的水平变化及意义。方法选取本院2018年10月至2019年6月收治的160例急性脑梗死(acute cerebral infarction,ACI)患者作为研究组,根据神经功能缺损程度分为轻度组(53例,NIHSS评分≤7分)、中度组(67例,7分19分),另选取同期在本院进行健康体检者64名作为对照组,采取酶循环法和尿酸酶法分别检测研究组发病48 h内、第7天以及对照组当天血清中Hcy、UA水平。结果研究组和对照组间高血压病史、糖尿病史、冠心病病史及吸烟史比较差异有统计学意义(P<0.05);而年龄、性别、BMI、饮酒史比较差异无统计学意义。研究组患者在发病48 h内血清Hcy与UA水平均明显高于对照组(P<0.05);研究组患者发病第7天的血清Hcy水平明显高于对照组,血清UA水平明显低于对照组,差异有统计学意义(P<0.05);研究组患者发病48 h内血清Hcy、UA水平均随NIHSS分级的增高而增加;Logistic回归分析显示,高Hcy水平是发生ACI的危险因素(OR=4.604,P=0.001),高UA水平与发生ACI无相关性(OR=1.772,P=0.344)。结论在ACI患者急性期内,血清Hcy水平呈升高趋势,可能是ACI发生的危险因素,可作为预测ACI患者疾病严重程度的指标,血清UA呈降低趋势,与ACI的发生无明显相关性,其作用机制有待进一步研究。
Objective To investigate the serum level of homocysteine(Hcy)and uric acid(UA)in patients with acute cerebral infarction before and after the hospital.Methods Selection in our hospital in October 2018 to June 2019 treated 160 cases of acute cerebral infarction(ACI)patients as a team,according to the degree of neurological deficit divided into mild group(53 cases,NIHSS score≤7 scores),moderate group(67 cases,7<NIHSS score≤19 scores)and severe group(40 cases,NIHSS score>19 scores).Another 64 cases of health checker were selected as the control group,The levels of Hcy and UA in the serum of the study group within 48 h,the 7th day and the control group were detected by enzyme cycle and uricase respectively.Results There were statistically significant differences in hypertension history,diabetes history,coronary heart disease history and smoking history between the study group and the control group(P<0.05).There were no statistically significant differences in age,sex,BMI or alcohol consumption history.The serum Hcy and UA levels in the study group were significantly higher than those in the control group within 48 h of the onset(P<0.05).The serum Hcy level of the study group was significantly higher than that of the control group in the 7th day,and the serum UA level was significantly lower than that of the control group,with statistically significant difference(P<0.05).In the study group,serum Hcy and UA levels increased with the increase of NIHSS grading within 48 h of onset.Logistic regression analysis showed that high Hcy level was a risk factor for ACI(OR=4.604,P=0.001),while high UA level was not associated with ACI(OR=1.772,P=0.344).Conclusion During the acute period of ACI patients,serum Hcy level showed an increasing trend,which may be a risk factor for the occurrence of ACI and can be used as an indicator to predict the disease severity of ACI patients.Serum UA showed a decreasing trend,which was not significantly correlated with the occurrence of ACI,and its mechanism of action needs further study.
作者
孟军红
张云霞
楚晓慧
Meng Junhong;Zhang Yunxia;Chu Xiaohui(Department of Neurology,The First Affiliated Hospital of Shihezi University Medical College,Shihezi,Xinjiang,832000,China)
出处
《当代医学》
2020年第27期72-76,共5页
Contemporary Medicine
关键词
血清同型半胱氨酸
血尿酸
急性脑梗死
神经功能缺损程度
Serum homocysteine
Serum uric acid
Acute cerebral infarction
Degree of neurological impairment
