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目的:探讨血浆同型半胱氨酸(Hcy)与脑卒中的关系。方法:采用微粒子酶免分析(MEIA)测定130例脑卒中患者(急性脑梗死90例、脑出血40例)和80例对照组血浆Hcy浓度,同时测定叶酸、维生素B12、血脂、空腹血糖等,进行Logistic回归分析。结果:卒中组平均血浆Hcy水平[(16.71±6.93)μmol·L-1]明显高于对照组「(10.16±2.71)μmol·L-1](t=8.07,P<0.001);两组中血浆Hcy升高分别有60例(46.15%)和5例(6.25%),差异有显著统计学意义(χ2=36.898,P<0.001)。卒中组平均血浆叶酸水平及维生素B12明显低于对照组;两组血浆Hcy浓度与叶酸及维生素B12水平均呈负相关。Hcy浓度与血压、血糖、血脂、尿酸无明显相关性。Logistic回归分析显示,高Hcy血症的OR值为5.272(95%CI:2.406￣11.552)。结论:高Hcy血症是脑卒中的独立危险因素;Hcy与叶酸、维生素B12呈负相关。
Objective: To investigate the relationship between plasma homocysteine (Hcy) and stroke. Methods: The concentrations of plasma Hcy in 130 stroke patients (90 acute cerebral infarction and 40 cerebral hemorrhage) and 80 control subjects were measured by MEIA. The concentrations of folic acid, vitamin B12, blood lipid and fasting blood glucose were determined simultaneously. Logistic regression analysis. Results: The average plasma Hcy level in stroke group was significantly higher than that in control group [(16.16 ± 6.93) μmol·L-1] (10.16 ± 2.71 μmol·L-1, t = 8.07, P <0.001) Plasma hcy increased in 60 cases (46.15%) and 5 cases (6.25%), the difference was statistically significant (χ2 = 36.898, P <0.001) .The mean plasma folate level and vitamin B12 in stroke group were significantly lower than those in control group ; There was a negative correlation between Hcy concentration and the level of folic acid and vitamin B12.The Hcy concentration had no significant correlation with blood pressure, blood glucose, blood lipid and uric acid.Logistic regression analysis showed that the OR of Hcy hyperlipidemia was 5.272 (95% CI : 2.406 ~ 11.552) .Conclusion: Hyperhomocysteinemia is an independent risk factor for stroke; Hcy is negatively correlated with folic acid and vitamin B12.