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目的:研究高血压脑出血患者血浆同型半胱氨酸(Hcy)水平变化及其预后评估价值。方法:选择2012年5月至2015年5月在我院接受治疗的高血压脑出血患者82例纳入观察组。根据患者入院时的格拉斯哥评分(GCS)对患者进行分组,其中轻型38例;中型25例;重型19例。所有患者均给予对症治疗后康复者41例,未愈者26例,死亡者15例。另选同期在我院接受健康体检者82例作为对照组,检测所有受检者血浆Hcy水平,分析患者的病情严重程度以及预后与其血浆Hcy水平的关系。结果:观察组中Hcy正常者的比例显著低于对照组,而Hcy升高者的比例显著高于对照组,差异均有统计学意义(均P<0.05)。观察组中各亚组的血浆Hcy水平均分别显著高于对照组,中、重型病情的患者Hcy水平显著高于轻型患者,且重型病情的患者Hcy水平显著高于中型患者,差异均有统计学意义(均P<0.05)。康复者的血浆Hcy水平显著低于未愈者及死亡者,差异有统计学意义(P<0.05)。根据Pearson法分析相关性可知,血浆Hcy水平与患者的病情严重程度呈明显正相关,与预后呈弱正相关。结论:监测高血压脑出血患者的血浆Hcy水平变化能够较好地判断其病情,对预后亦具有一定的评估价值,值得临床重视。
Objective: To investigate the changes of plasma homocysteine (Hcy) level and its prognostic value in patients with hypertensive intracerebral hemorrhage. Methods: 82 patients with hypertensive intracerebral hemorrhage treated in our hospital from May 2012 to May 2015 were included in the observation group. Patients were grouped according to the Glasgow score (GCS) at hospital admission, of which 38 were light, 25 were medium, and 19 were heavy. All patients were given symptomatic treatment after rehabilitation in 41 cases, 26 cases of unhealed, 15 cases of death. In the same period, 82 healthy subjects in our hospital were selected as the control group. Plasma Hcy levels were measured in all subjects. The severity of the disease and the relationship between prognosis and plasma Hcy level were analyzed. Results: The proportion of patients with normal Hcy in the observation group was significantly lower than that in the control group, while the proportion of patients with elevated Hcy was significantly higher than that in the control group (all P <0.05). Hcy levels in each subgroup in the observation group were significantly higher than those in the control group. The Hcy levels in patients with moderate and severe disease were significantly higher than those in the light-weight patients, and the Hcy levels in the patients with severe disease were significantly higher than those in the medium-sized patients Significance (all P <0.05). The plasma homocysteine level of the recovered person was significantly lower than that of the unhealed person and the deceased person, the difference was statistically significant (P <0.05). Pearson analysis according to the correlation shows that plasma Hcy levels and the severity of the disease was positively correlated with the prognosis was a weak positive correlation. Conclusion: The monitoring of plasma Hcy levels in patients with hypertensive intracerebral hemorrhage can judge the condition of the disease better and has a certain value in prognosis. It is worthy of clinical attention.