本文選題：高同型半胱氨酸血癥 + 腦梗死　； 參考：《第四軍醫(yī)大學(xué)》2013年碩士論文

【摘要】：研究背景和目的：腦梗死（cerebralinfarction，，CI）是由于各種原因所致局部腦組織區(qū)域性血液供應(yīng)障礙，產(chǎn)生缺血缺氧性壞死病變，導(dǎo)致與病灶相對應(yīng)的神經(jīng)功能缺失癥狀。CI患者發(fā)病后短期內(nèi)肢體癱瘓的康復(fù)最為關(guān)鍵，直接影響到遠期預(yù)后，因此研究CI患者短期預(yù)后的主要影響因素，并采取適當?shù)念A(yù)防措施，對減輕CI患者的肢體癱瘓程度尤為重要。本項研究針對初次發(fā)病的CI患者測定其空腹血漿同型半胱氨酸水平，將CI患者分為非HHcy組、輕度HHcy和中度HHcy組，通過測定血漿中VitB12、葉酸和血脂水平，探討HHcy的可能影響因素；在此基礎(chǔ)上，通過改良Rankin量表（MRS）評分，觀察經(jīng)過給予相同方案治療后，非HHcy組與HHcy組CI患者短期肢體神經(jīng)功能缺損恢復(fù)的情況。 研究方法：以初次發(fā)病的CI患者為研究對象，根據(jù)血漿同型半胱氨酸水平將CI患者分為非HHcy組和HHcy組，其中HHcy組又分為輕度HHcy組和中度HHcy組。（1）觀察非HHcy組、輕度HHcy組和中度HHcy組之間患者葉酸、VitB12及血脂之間的差別，探討HHcy的相關(guān)影響因素；（2）觀察非HHcy組和HHcy組入院時及治療14天后改良Rankin量表（MRS）評分變化情況，探討HHcy對CI患者短期肢體神經(jīng)功能缺損恢復(fù)的影響。 研究結(jié)果：（1）中度HHcy組和輕度HHcy組患者VitB12、Fa和HDL水平較非HHcy組顯著降低，且中度HHcy組較輕度HHcy組的水平更低，而各組中TG、TC和LDL無顯著差別。（2）入院時非HHcy組和HHcy組MRS評分生活自理（≤2分）人數(shù)和不能自理（≥3分）人數(shù)的百分比無統(tǒng)計學(xué)差異，經(jīng)相同藥物治療14天后，非HHcy組生活自理人數(shù)的百分比較HHcy組顯著升高（P0.01），不能自理人數(shù)的百分比較HHcy組顯著降低（P0.01），非HHcy組中MRS評分改善人數(shù)的百分比較HHcy組顯著升高（P0.01）。 研究結(jié)論：（1）急性CI患者血漿中Hcy水平與VitB12、Fa和HDL水平呈負性相關(guān)，而與TG、TC和LDL無明顯的相關(guān)性。（2）急性CI患者中HHcy顯著影響其短期內(nèi)神經(jīng)功能缺損癥狀的康復(fù)，降低Hcy水平對于改善CI患者短期預(yù)后有重要的臨床意義。
[Abstract]:Background and objective: cerebral infarction (CI) is a regional blood supply disorder caused by various causes, resulting in ischemic and hypoxic necrosis. The recovery of limb paralysis in the patients with neurological deficit corresponding to the focus. The recovery of limb paralysis within a short period of time after onset of CI is the most critical, which directly affects the long-term prognosis. Therefore, the main influencing factors of short-term prognosis of CI patients are studied. It is very important to take appropriate preventive measures to reduce the degree of paralysis in CI patients. In this study, fasting plasma homocysteine levels were measured in CI patients with primary onset. Patients with CI were divided into three groups: non-Hcy group, mild HHcy group and moderate HHcy group. The levels of VitB12, folic acid and blood lipids in plasma were determined to explore the possible influencing factors of HHcy. On this basis, the short-term recovery of limb neurological impairment in CI patients of non-Hcy group and HHcy group was observed by modified Rankin scale (Mrs). Methods: according to plasma homocysteine level, CI patients were divided into non-Hcy group and HHcy group. HHcy group was divided into mild Hcy group and moderate Hcy group. (1) Non-Hcy group was observed. The difference of folate VitB12 and serum lipids between mild HHcy group and moderate HHcy group, to explore the related factors of HHcy. (2) to observe the changes of modified Rankin scale (Mrs) score on admission and 14 days after treatment in non-Hcy group and Hcy group. To investigate the effect of HHcy on the recovery of short-term limb nerve function defect in patients with CI. The results showed that: (1) the levels of VitB12Fa and HDL in moderate HHcy group and mild HHcy group were significantly lower than those in non-HHcy group, and the level in moderate HHcy group was lower than that in mild HHcy group. However, there was no significant difference in TGG TC and LDL between the groups. (2) there was no significant difference in the percentage of patients with MRS scores of self-care (鈮

本文編號：2072234