探讨血清同型半胱氨酸水平与脑梗死rt-PA静脉溶栓预后的关系.docVIP

精品论文 参考文献 探讨血清同型半胱氨酸水平与脑梗死rt-PA静脉溶栓预后的关系 孙婷婷 1 张佩兰2 　　（1天津医科大学 天津 300070） 　　（2天津市环湖医院 天津 300060） 　　【摘要】目的：探讨血清同型半胱氨酸（HCY）水平与急性脑梗死患者行rt-PA静脉溶栓治疗预后的关系。方法：回顾性分析自2014年6月至2015年6月天津市环湖医院神经内科收治的急性脑梗死行rt-PA静脉溶栓治疗的患者740例。其中血清HCY水平正常患者328例，血清HCY升高患者412例，分别记录两组患者治疗前、治疗后24h及治疗后7d的NHISS评分，治疗前、治疗后30d、治疗后90d的mRS评分。分析血清HCY水平与急性脑梗死rt-PA静脉溶栓治疗预后的关系。结果：血清HCY升高组患者治疗后的NIHSS评分及mRS评分均较血清HCY正常组高。结论：血清同型半胱氨酸水平升高是导致急性脑梗死患者rt-PA静脉溶栓预后不良的因素之一。 　　【关键词】同型半胱氨酸；脑梗死；静脉溶栓 　　【中图分类号】R742 【文献标识码】A 【文章编号】1007-8231（2015）19-0108-02 　　【Abstract】Objective To investigate the relationship between serum homocysteine (HCY) levels and prognosis of patients with acute cerebral infarction treated with rt-PA intravenous thrombolytic therapy. Methods Retrospective analysis was performed in 740 patients with acute cerebral infarction treated with rt-PA intravenous thrombolysis in the Department of internal medicine, Tianjin Huanhu Hospital from June 2014 to June 2015. The serum HCY level of normal patients in 328 cases, 412 cases of patients with elevated serum HCY, The two groups of patients were recorded before treatment, after treatment 24h and after treatment 7d NHISS score, before treatment, after treatment 30d, after treatment 90d mRS score. Analysis of the relationship between serum HCY level and prognosis of patients with acute cerebral infarction treated with rt-PA intravenous thrombolysis. Results The NIHSS score and mRS score after treatment in the patients with elevated serum HCY were higher than those in the normal group of serum HCY. Conclusion The increase of serum homocysteine level is one of the factors that lead to poor prognosis of rt-PA intravenous thrombolysis in patients with acute cerebral infarction. 　　【Key words】Homocysteine;Cerebral infarction; Intravenous thrombolysis 　　急性脑梗死已成为全球范围的公共卫生问题，具有发病率高、致残率高和致死率高的特点。近年来发达国家的脑梗死的死亡率逐年下降的趋势，而在我国死亡率则存在持续趋势，到2004年我每年死于急性脑梗死的患者人数已上升到了170万，已经升至第1位[1]。脑梗死又有很高的致残率，在所有能够存活下来的急性脑梗死患者中，大约有67%的患者存在着不同严重程度的神经