【摘要】 目的探讨高同型半胱氨酸(Hcy)血症与脑梗死复发的相关性及预测价值。方法回顾性分析2017年11月～2018年4月我院住院的急性脑梗死(发病后7 d内)患者110例,根据入院时是否为脑梗死复发分为复发组40例和非复发组70例。收集患者基线血清Hcy水平。采用logistic回归分析Hcy水平与脑梗死复发的关系。采用ROC曲线分析血清Hcy水平预测脑梗死复发的作用。结果复发组血清Hcy水平明显高于非复发组,差异有统计学意义[(20.25±9.97)μmol/L vs(16.05±5.38)μmol/L,P=0.017]。多因素logistic回归分析显示,血清Hcy水平是急性脑梗死复发的危险因素(OR=1.082,95%CI:1.018～1.150,P=0.011)。血清Hcy水平预测脑梗死复发的ROC曲线下面积为63.3%(95%CI:0.520～0.747),最大约登指数0.289,截断值为17.2μmol/L,敏感性为0.575,特异性为0.714。结论高Hcy血症和脑梗死患者的复发相关,脑梗死患者血清Hcy>17.2μmol/L有复发风险。更多还原

【Abstract】 Objective To study the relationship between hyperhomocysteinemia and recurrence of cerebral infarction and the value of serum Hcy level in predicting recurrence of cerebral infarction.Methods One hundred and ten acute cerebral infarction(ACI) patients admitted to our hospital from November 2017 to April 2018 were divided into recurrent ACI group(n=40) and non-recurrent ACI group(n=70).Their baseline serum Hcy level was measured.The relationship between serum level of Hcy and recurrence of cerebral infarction was analyzed by logistic regression analysis.The role of serum Hcy level in predicting recurrence of cerebral infarction was analyzed by ROC curve analysis.Results The serum Hcy level was significantly higher in recurrent ACI group than in non-recurrent ACI group(20.25±9.97 μmol/L vs 16.05±5.38 μmol/L,P=0.017).Multivariate logistic regression analysis showed that serum Hcy level was a risk factor for recurrence of ACI(OR=1.082,95%CI:1.018-1.150,P=0.011).The AUC for serum Hcy level to predict the recurrence of cerebral infarction was 63.3%(95%CI:0.520-0.747) with a maximum Youden index of 0.289,a cut-off value of 17.2 μmol/L,a sensitivity of 0.575 and a specificity of 0.714.Conclusion Hyperhomocysteinemia is related with the recurrence of cerebral infarction in ACI patients.ACI patients with their serum Hcy level >17.2 μmol/L are at risk of recurrence.更多还原