临床与病理杂志2023，Vol.43Issue(10)：1816-1821,6.DOI:10.11817/j.issn.2095-6959.2023.230122
高同型半胱氨酸血症与急性脑梗死预后的相关性
Correlation between hyperhomocysteinemia and the prognosis in acute cerebral infarction
摘要
Abstract
Objective:Hyperhomocysteinemia is closely related to the occurrence and development of acute cerebral infarction.This study explores the relationship between hyperhomocysteinemia and the prognosis of patients with acute cerebral infarction. Methods:Patients with acute cerebral infarction who met the criteria in Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,from October 2021 to February 2023 were retrospectively analyzed.The modified Rankin Scale(mRS)was used to evaluate the prognosis of patients 3 months after the onset.An mRS score of≤2 was defined as a good prognosis,while an mRS score of>2 was defined as a poor prognosis.Univariate analysis was used to analyze the factors associated with prognosis.Factors showing statistical significance in univariate analysis were further analyzed using receiver operator characteristic(ROC)curve analysis and multivariate logistic regression analysis to determine their diagnostic value for prognosis and identify independent influencing factors for prognosis. Results:A total of 220 cases were collected,including 126 cases in the good prognosis group and 94 cases in the poor prognosis group.There were statistically significant differences between the 2 groups in terms of diabetes(χ2=9.881,P=0.002),history of previous stroke or transient ischemic attack(χ2=5.113,P=0.024),hyperhomocysteinemia(χ2=5.611,P=0.018),blood glucose(t=-2.577,P=0.011),homocysteine(t=-2.694,P= 0.008),and National Institutes of Health Stroke Scale(NIHSS)score(Z=-5.791,P<0.001).Homocysteinemia had diagnostic value for predicting the prognosis of ischemic stroke,with the optimal cut-off value of 17.205 μmol/L,a Youden index of 0.286,sensitivity of 72.3%,and specificity of 56.3%.Multivariate logistic regression analysis showed that hyperhomocysteinemia(OR=2.154,95%CI 1.107 to 4.192),diabetes(OR=2.632,95%CI 1.307 to 5.301),and high NIHSS score(OR=1.395,95%CI 1.245 to 1.564)were independent risk factors for poor prognosis in acute cerebral infarction. Conclusion:Hyperhomocysteinemia is an independent risk factor for poor prognosis in patients with acute cerebral infarction.关键词
高同型半胱氨酸血症/急性脑梗死/预后/相关性Key words
hyperhomocysteinemia/acute cerebral infarction/prognosis/relevance引用本文复制引用
马彬,陈晓,李笑仙,戴璇,程记伟,张利军..高同型半胱氨酸血症与急性脑梗死预后的相关性[J].临床与病理杂志,2023,43(10):1816-1821,6.基金项目
上海市普陀区临床特色专病建设项目(2023tszb04) （2023tszb04）
上海市普陀区卫生健康委员会重点项目(ptkwws201902).This work was supported by the Clinical Characteristic and Special Disease Construction Project in Putuo district,Shanghai(2023tszb040)and the Key Project of Shanghai Putuo District Health Commission(ptkwws201902),China. （ptkwws201902）
