急性脑卒中病因学分型和病变部位与血浆同型半胱氨酸水平的临床关系

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Abstract Objective To explore the clinical relationship between the etiological type and lesion site of acute cerebral apoplexy and plasma homocysteine (Hcy)level,and to analyze the influence of abnormal elevated plasma Hcy level on the factors risk of acute cerebral apoplexy.Methods A total of 268 patients with acute cerebral apoplexy admitted to our hospital from June 2016 to August 2017 were selected as the observation group,among them,there were 98 cases of large atherosclerotic type,103 cases of small atherosclerotic type,41 cases of cardiogenic embolic type,17 cases of other clear etiological type,9 cases of other undefined etiological type.There were 126 cases of intracranial lesions,83 cases of extracranial lesions and 59 cases of intracranial and extracranial lesions.The level of plasma Hcy in the patients with acute cerebral apoplexy of different etiological types and lesion site were compared,and the influence of abnormal increase of plasma Hcy level on the risk factors of acute cerebral apoplexy were analyzed.Results The Hcy level of the observation group was(19.37±7.01)μmol/L,which was higher than that of the control group([13.25±2.31]μmol/L),the difference was statistically significant(P<0.05).Logistic regression analysis showed that the abnormal increase of plasma Hcy level(>15 μmol/L)was an independent risk factor for acute stroke (β=0.216,SE=0.064,Wald χ2=10.038，P=0.011,OR=1.241,95%CI:1.112-1.429).There was significant difference in plasma Hcy level between acute cerebral apoplexy patients with different etiological factors(P<0.05).The levels of plasma Hcy in the large atherosclerotic type were the highest,and the plasma Hcy level of the cardiogenic embolic type was the second,followed by the cerebral apoplexy of small atherosclerotic type,the cerebral apoplexy with definite cause,and the cerebral apoplexy patients with unclear cause,the differences were statistically significant among all types(P<0.05).There was significant difference in plasma Hcy level between cerebral apoplexy patients with different lesions site (P<0.05).Among them,the plasma Hcy level was the highest in intracranial and extracranial lesions,the plasma Hcy level in intracranial lesions was the second,and the plasma Hcy level in extracranial lesions was the lowest,the differences were statistically significant among all the lesion site (P<0.05).Conclusion There is a significant difference in the level of plasma Hcy in patients with acute cerebral apoplexy with different etiological type and different lesion sites,and the abnormal increase of plasma Hcy is an independent risk factor for acute cerebral apoplexy.

Key words： Acute cerebral apoplexy Etiological type and lesion site Plasma homocysteine Risk factor

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	FANG Ming

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FANG Ming. Clinical relationship between the etiological type and lesion site of acute cerebral apoplexy and plasma homocysteine level[J]. 中国当代医药, 2018, 25(28): 62-65.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2018/V25/I28/62

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