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目的 :检测脑血栓形成患者血浆同型半胱氨酸 (HCY)浓度 ,探讨其与患者脑梗死临床亚型及疾病严重程度的关系。方法 :应用Waters公司Baseline 810型高效液相色谱仪 ,HPLC -FD法测定 87例急性脑血栓形成患者和 80例对照者血浆HCY浓度 ,入院 3d内病情稳定后完成脑血栓形成患者临床神经功能缺损程度评分和按OCSP(OxfordCommunityStrokeProject)完成脑梗死临床分型。结果 :病例组空腹血浆HCY浓度 (15 .2 8± 4 .33umol/L)较对照组 (11.32± 3.86umol/L)高 (P <0 .0 0 1) ,两组中血浆HCY升高者分别为 31% (2 7/ 87)和 6 .3% (5 / 80 ) (P <0 .0 0 1) ;病例组 87例 ,按 0CSP脑梗死临床分型法分为TACⅠ 10例、PACI 5 6例、POCI 9例和LACI 12例 ,血浆HCY浓度各为 13.39± 2 .0 9、15 .16± 4 .5 6、16 .16± 3.86和 16 .77± 4 .6 4umol/L(F =1.2 6 3,P =0 .2 93) ;按改良爱丁堡 -斯堪的那维亚神经功能缺损程度评分标准将病例组患者分为轻型 4 3例、中型 36例和重型 8例 ,血浆HCY浓度各为 15 .6 3± 4 .4 8、14 .90± 4 .33和 15 .11± 3.76umol/L(F =0 .2 77,P=0 .75 8)。结论 :高HCY血症是脑血栓形成的独立危险因素 ,研究未显示血浆Hcy浓度与脑梗死临床分型和神经功能缺损程度有关。
Objective: To detect the concentration of plasma homocysteine (HCY) in patients with cerebral thrombosis and to explore its relationship with the clinical subtype of cerebral infarction and the severity of the disease. Methods: The concentrations of plasma HCY in 87 patients with acute cerebral thrombosis and 80 controls were determined by Waters Baseline 810 high performance liquid chromatography with HPLC-FD. The clinical neurological deficits in patients with cerebral thrombosis Degree score and according to OCSP (OxfordCommunityStrokeProject) to complete the clinical classification of cerebral infarction. Results: The fasting plasma HCY concentration in case group was higher (15.28 ± 4.33umol / L) than that in control group (11.32 ± 3.86umol / L) (P <0.01) (P <0.01). The cases were divided into 87 cases according to 0CSP cerebral infarction clinical classification and 10 cases were TAC Ⅰ, PACI 5 6 cases, 9 cases of POCI and 12 cases of LACI. The concentrations of plasma HCY were 13.39 ± 2 .0 9,15 .16 ± 4. 5 6,16 .16 ± 3.86 and 16 .77 ± 4. 64umol / L ( F = 1.2 6 3, P = 0.223). According to the modified Edinburgh-Scandinavian score of neurological deficit score, the patients were divided into three groups: light type, middle type and heavy type, and plasma type HCY concentrations were 15.63 ± 4.48, 14.90 ± 4.33 and 15.11 ± 3.76 umol / L, respectively (F = 0.277, P = 0.758). Conclusions: Hyperhomocysteinemia is an independent risk factor for cerebral thrombosis. However, it has not been shown that the concentration of Hcy is related to the clinical classification of cerebral infarction and the degree of neurological deficits.