标题：血清同型半胱氨酸、纤维蛋白原与急性缺血性脑卒中预后的相关性研究

      作者：何明 1，何继荣 1，宋永建 2
    (1.上海交通大学医学院附属瑞金医院卢湾分院神经内科，上海 200020；
2.上海交通大学医学院附属瑞金医院神经内科，上海 200020)

      卷次： 2016年27卷19期

      【摘要】 目的 探讨血清同型半胱氨酸(Hcy)、纤维蛋白原(Fib)与急性缺血性脑卒中(AIS)预后的关系。
方法 选择 2014年 1月至2015年6月期间我院收治的150例急性缺血性脑卒中患者作为研究对象，选择同期50
例健康体检者作为对照组。根据临床神经功能缺损程度评分(CNDS)将AIS患者分为轻度缺损组(n=36)、中度缺损
组(n=84)及重度缺损组(n=30)，并根据患者不同预后将其分为预后良好组(n=61)与预后不佳组(n=89)；比较不同研
究对象间血清Hcy、Fib水平。结果 观察组患者血清Hcy、Fib水平分别为(19.64±5.49) ?mol/L、(4.35±1.42) g/L，均
明显高于对照组的(8.63±3.61) ?mol/L、(2.79±0.62) g/L，差异均有统计学意义(P<0.05)；血清Hcy、Fib水平在轻度缺
损组为(15.14±2.19) ?mol/L和(4.06±0.22) g/L、中度缺损组为(18.79±2.46) ?mol/L和（4.25±0.33）g/L，重度缺损组为
（24.13±2.71) ?mol/L和(5.46±0.29) g/L，三组患者的Hcy、Fib水平均依次升高，差异均有统计学意义(P<0.05)；预后不
佳组患者血清Hcy、Fib水平分别为(21.68±7.63) ?mol/L和（4.98±1.24）g/L，明显高于预后良好组的(17.24±6.19) ?mol/L
和(4.21±1.38) g/L，差异均有统计学意义(P<0.05)。结论 血清Hcy、Fib水平与急性缺血性脑卒中患者病情严重程
度及预后密切相关，临床可通过检测血清Hcy、Fib水平对患者疾病严重程度及预后进行评估。

      【关键词】 急性缺血性脑卒中；同型半胱氨酸；纤维蛋白原；预后；相关性

      【中图分类号】 R743.33 【文献标识码】 A 【文章编号】 1003—6350（2016）19—3124—03


Relationship of prognosis with homocysteine and fibrinogen in patients with acute ischemic stroke.
HE Ming 1, HE
Ji-rong 1, SONG Yong-jian 2. 1. Department of Neurology, Luwan Branch of Ruijin Hospital, Shanghai Jiao Tong University
School of Medicine, Shanghai 200020, CHINA; 2. Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University
School of Medicine, Shanghai 200020, CHINA

【Abstract】 Objective To investigate the relationship of prognosis with homocysteine (Hcy) and fibrinogen
(Fib) in patients with acute ischemic stroke (AIS). Methods A total of 150 cases of patients with acute ischemic stroke,
who were treated in our hospital from January 2014 to June 2015, were selected as the observation group. At the same time,
50 cases of healthy persons were enrolled in the control group. The AIS patients were divided into mild damage group (n=
36), moderate defect group (n=84) and severe defect group (n=30) according to the clinical neural function defect score
(CNDS), and they were also divided into good prognosis group (n=61) and poor prognosis group (n=89) according to the
different prognosis. The serum Hcy, Fib level in the different groups were compared. Results The serum Hcy, Fib level in
the observation group ((19.64±5.49) ?mol/L, (4.35±1.42) g/L, respectively) were significantly higher than those in the con-
trol group, (8.63±3.61) ?mol/L, (2.79±0.62) g/L, respectively, P<0.05; the serum Hcy and Fib level in mild defect group
((15.14±2.19) ?mol/L, (4.06±0.22) g/L, respectively), moderate defect group ((18.79±2.46) ?mol/L, (4.25±0.33) g/L, respec-
tively) and severe defect group ((24.13±2.71) ?mol/L, (5.46±0.29) g/L, respectively) were increased gradually, and the dif-
ference was statistically significant (P<0.05); the serum Hcy, Fib level in the poor prognosis group ((21.68±7.63) ?mol/L,
(4.98±1.24) g/L, respectively) were significantly higher than those in the good prognosis group ((17.24±6.19) ?mol/L,
(4.21±1.38) g/L, respectively), P<0.05. Conclusion The serum Hcy and Fib are closely related to the severity and prog-
nosis of patients with AIS, which can be used to assess the severity and prognosis of patients with AIS.

      【Key words】 Acute ischemic stroke (AIS); Homocysteine (Hcy); Fibrinogen (Fib); Prognosis; Relationship
·论 著·doi:10.3969/j.issn.1003-6350.2016.19.009