【摘要】 目的 探讨15岁～44岁青年患者首发急性脑梗死Hcy、HbA1c、UA水平变化及对疾病预后的预测价值。方法 选取2020年1月10日-2021年10月25日某院收治的105例首发急性青年脑梗死患者，根据3个月的预后分为预后不良组17例、预后良好组88例。比较两组Hcy、HbA1c、UA水平，分析与NIHSS评分的相关性及预后预测价值。结果 预后良好组入院后7天、入院后14天Hcy(15.07±3.24、14.24±2.31)μmol/L、HbA1c(4.86±0.52、4.80±0.50)%、UA(351.03±50.29、324.78±36.36)μmol/L低于治疗前Hcy(18.76±6.91)μmol/L、HbA1c(5.16±0.87)%、UA(382.26±18.17)μmol/L(P<0.05)；预后不良组治疗前、入院后7天、入院后14天Hcy、HbA1c、UA水平、NIHSS评分高于预后良好组(P<0.05)；治疗前、入院后7天、入院后14天Hcy(r=0.608、0.689、0.767)、HbA1c(r=0.606、0.645、0.811)、UA(r=0.746、0.808、0.859)水平与对应时间点NIHSS评分呈正相关(P<0.05);Hcy、HbA1c、UA水平联合预测预后的AUC为0.947，大于单一指标预测(P<0.05)。结论 血清Hcy、HbA1c、UA水平与首发急性青年脑梗死患者病情进展和预后转归相关，三者联合预测患者预后，指导临床治疗。更多还原

【Abstract】 Objectives This study aims to investigate the changes in Hcy, HbA1c and UA levels in first acute cerebral infarction in young patients and their predictive value for disease prognosis. Methods 105 patients with first acute young cerebral infarction admitted to a hospital from January 10, 2020 to October 25, 2021 were selected. 17cases were divided into the poor prognosis group, and 88 cases were divided into the good prognosis group according to their prognosis at 3 months. The levels of Hcy, HbA1c and UA were compared between the two groups, and the correlation with NIHSS score and prognostic predictive value were analyzed. Results Hcy(15.07±3.24, 14.24±2.31) μmol/L, HbA1c(4.86%±0.52, 4.80%±0.50), UA(351.03±50.29, 324.78±36.36) μmol/L in the good prognosis group 7 d after admission and 14 d after admission were lower than the pre-treatment Hcy(18.76±6.91) μmol/L, HbA1c(5.16%±0.87), UA(382.26±18.17) μmol/L(P<0.05). In 7d and 14d after admission, Hcy, HbA1c, UA levels, and NIHSS scores were higher in the poor prognosis group than in the good prognosis group before treatment(P<0.05). Hcy(r=0.608, 0.689, 0.767), HbA1c(r=0.606, 0.645,0.811), UA(r=0.746, 0.808, 0.859) levels before treatment, 7d, and 14d after admission were positively correlated with the NIHSS scores at the corresponding time points(P<0.05). AUC for joint prediction of prognosis from Hcy, HbA1c, UA levels was 0.947, which was greater than that predicted by a single index(P<0.05).Conclusions Serum Hcy, HbA1c, and UA levels were associated with the progression and prognostic outcome of young patients with first acute cerebral infarction. The combination of the three predicted patient prognosis and guided clinical treatment.更多还原