摘要
目的探讨血浆同型半胱胺酸(Hcy)水平检测对急性脑梗死患者预后的临床诊断价值。方法根据入院时Hcy水平的中位数值,将78例急性脑梗死伴高同型半胱氨酸血症患者分为高Hcy组与低Hcy组,同时选取同期35例急性脑梗死伴Hcy水平正常者作为对照组,入院后均进行脑血管疾病二级预防。在此基础上,高、低Hcy组给予维生素B12。入院第1天及治疗第21天,分别对3组进行巴氏量表(BI)及美国国家卫生研究院卒中量表(NIHSS)评分,检测其Hcy水平,并比较高、低Hcy组的临床疗效。结果治疗第21天,高、低Hcy组Hcy水平较第1天明显降低;入院第1天及治疗第21天,高、低Hcy组Hcy水平均明显高于对照组,且高Hcy组升高幅度更大。治疗第21天,3组NIHSS评分均明显下降,而BI评分明显升高;入院第1天及治疗第21天,高、低Hcy组NIHSS评分明显高于对照组,而BI评分明显低于对照组,且高Hcy组NIHSS评分显著高于低Hcy组,而BI评分显著低于低Hcy组。低Hcy组总有效率明显高于高Hcy组。结论检测Hcy水平可在一定程度上预测急性脑梗死患者的预后,降低Hcy水平可有效缓解患者的神经功能缺损,提高生活自理能力。
Objective To explore the clinical diagnostic value of plasma homocysteine （Hcy） in the prognosis of patients with acute cerebral infarction （ACI）. Methods According to Hcy median value on admission, 78 ACI patients with hyperhomocysteinemia were divided into high -Hcy group and low-Hcy group, and meanwhile 34 ACI patients with normal Hcy level were designed as control group. All patients were given the secondary prevention for cerebrovascular dis- ease. On the basis of conventional therapy, high-Hcy group and low-Hcy group were treated with vitamin B12. BI and NIHSS scores were respectively evaluated, and Hcy level was detected in 3 groups on first day of admission and 21st day of treatment, and the clinical efficiency was compared between high-Hcy group and low-Hcy group. Results Hcy levels in high-Hcy group and low-Hcy group decreased significantly on 21st day of treatment. Hcy levels in high-Hcy grouy and low-Hcy group were significantly higher than control group on first day of admission and 21st day of treat- ment, and the increasing range in high-Hcy group was even larger. NIHSS scores decreased, while BI scores increased significantly in 3 groups on 21st day of treatment. NIHSS scores in high-Hcy group and low-Hcy group were significantly higher than control group on first day of admission and 21st day of treatment, while BI scores were lower, and the increasing and decreasing ranges in high-Hcy group were even larger. The overall response rate of low-Hcy group was superior to high-Hcy group. Conclusion Detecting Hcy level can predict the prognosis of patients with ACI, and reduc- ing Hcy level can improve the neural functional defects and life capability of patients.
出处
《实用临床医药杂志》
CAS
2014年第7期17-19,23,共4页
Journal of Clinical Medicine in Practice
基金
中国高校医学期刊临床专项资金(11321642)
