急性脑卒中患者血浆Hcy 与脑白质疏松、 PSCAD 的相关性分析

Relation between plasma Hcy with leukoaraiosis and PSCAD in acute stroke patients

摘要:

目的 探讨急性脑卒中患者血浆同型半胱氨酸（Hcy）与脑白质疏松、卒中后焦虑抑郁共病 （PSCAD）的关系。方法 回顾性分析270 例急性脑卒中患者临床资料，按照脑白质疏松（LA）严重程度分 为轻度LA 组和中重度LA 组，按照是否存在PSCAD 状态分为PSCAD 组和非PSCAD 组，所有患者均于入 院后第2 天抽取肘静脉血检测血浆Hcy 水平，分析血浆Hcy 水平与LA、PSCAD 的关系。结果 中重度LA 组患者年龄、高血压、吸烟、中重度梗死及血浆Hcy 水平高于轻度LA 组（P <0.05），PSCAD 组高血压、饮 酒、基底节区和额叶区梗死、中重度梗死及血浆Hcy 水平高于非PSCAD 组（P <0.05）；年龄、高血压及血 浆Hcy 水平是中重度LA 的独立危险因素（P <0.05），饮酒、血浆Hcy 水平是PSCAD 的独立危险因素（P <0.05）。 血浆Hcy 水平与LA、PSCAD 呈正相关（P <0.05）。结论 通过检测血浆Hcy 水平能够在一定程度上反应 LA 病情和焦虑抑郁程度，为临床治疗和预后监测提供依据。

Abstract:

Objective To explore the relations of plasma homocysteine (Hcy) level with leukoaraiosis and post-stroke comorbid anxiety and depression (PSCAD) in acute stroke patients. Methods The clinical data of 270 cases of acute stroke patients were retrospective analyzed. According to the leukoaraiosis severity (LA) they were divided into a mild LA group and a moderate and severe LA group. According to the PSCAD status they were divided into a PSCAD group and a non-PSCAD group. Elbow vein blood was extracted in all patients on the 2nd day after admission for detection of plasma Hcy level, and the relationships of plasma Hcy level with LA and PSCAD were analyzed. Results The age was older, the hypertension ratio, the smoking ratio, the rate of moderate and severe infarction and the plasma Hcy level were significantly higher in the moderate and severe LA group compared to the mild LA group (P < 0.05). The hypertension ratio, drinking ratio, the rate of basal ganglia and frontal lobe infarction, the rate of moderate and severe infarction and the plasma Hcy level in the PSCAD group were significantly higher than those in the non-PSCAD group (P < 0.05). Logistic regression analysis showed that age, hypertension and plasma Hcy level were the independent risk factors for moderate and severe LA (P < 0.05); drinking and plasma Hcy level were the independent risk factors for PSCAD (P < 0.05). Correlation analysis showed that plasma Hcy level was positively correlated with the severity of LA and the degree of anxiety and depression (P < 0.05). Conclusions Plasma Hcy level is positively correlated with the severity of LA and the degree of anxiety and depression.