本文選題：高同型半胱氨酸血癥 + 腦梗死　； 參考：《吉林大學》2014年碩士論文

【摘要】：腦梗死是一種嚴重危害人類健康的重要疾病，具有高發(fā)病率、高復發(fā)率、高致殘率和高死亡率的特性，缺血性腦卒中已成為我國死亡率及致殘率最高的疾病。腦血管病防治的關鍵在于預防，對于危險因素的控制尤為重要。一些傳統(tǒng)危險因素如高血壓、糖尿病、吸煙、飲酒、肥胖、血脂異常等與腦梗死的相關性已被人們熟知，隨著研究的深入，眾多研究發(fā)現(xiàn)，高同型半胱氨酸血癥是一個新的腦血管病危險因素。目前國內外關于高同型半胱氨酸血癥與腦梗死相關性的研究尚無定論，降低血漿同型半胱氨酸是否能減少腦血管病的發(fā)病仍存在爭議。本研究選取東北地區(qū)腦梗死的病人為研究對象，探討HHcy與腦梗死及傳統(tǒng)危險因素的相關性，旨為缺血性腦血管病的篩查及預防提供新的線索。 本研究選擇2012年9月至2013年9月期間吉林大學白求恩第一醫(yī)院神經內科住院的腦梗死患者為研究對象，，主要做了以下研究：①所有入組腦梗死患者伴有不同程度HHcy所占比例分析。②依據(jù)TOAST分型將所有樣本1023例分為5組，分別比較各組間HHcy的差異。③根據(jù)頸動脈中內膜厚度（IMT）是否增厚分為：IMT增厚組（IMT≥1mm）及IMT正常組（IMT＜1mm），比較2組HHcy的差異。④根據(jù)空腹血清Hcy水平分為：HHcy組（Hcy≥15μmol/L）及非HHcy組（Hcy＜15μmol/L），系統(tǒng)分析2組之間性別、年齡、高血壓、糖尿病、血脂、吸煙、飲酒的差異。⑤統(tǒng)計分析血清Hcy水平與其主要影響因素葉酸、維生素B12以及飲食習慣之間的相關性。 主要研究結果如下：①所有1023例腦梗死患者68.9%（705/1023）伴有高同型半胱氨酸血癥，其中輕度HHcy占67.4%（475/705），中度HHcy占26.1%（184/705），重度HHcy占6.5%（46/705）。②TOAST分型各亞型HHcy的差異：LA組發(fā)生HHcy的概率均大于其他各組，差異有統(tǒng)計學意義（P＜0.05）。③IMT增厚組較IMT正常組更易發(fā)生HHcy，差異有統(tǒng)計學意義（P＜0.05）。④血清Hcy與葉酸、維生素B12呈線性負相關，葉酸及維生素B12缺乏與HHcy的發(fā)生顯著相關，經常進食蔬菜可減少HHcy的發(fā)生。 結論：①HHcy與腦梗死的發(fā)病具有顯著相關性。②HHcy與大動脈粥樣硬化型腦梗死發(fā)生及頸動脈粥樣硬化程度顯著相關。③血清Hcy濃度與葉酸、維生素B12呈負相關，經常進食蔬菜可減少HHcy的發(fā)生。
[Abstract]:Cerebral infarction is an important disease that seriously endangers human health. It has the characteristics of high morbidity, high recurrence rate, high disability rate and high mortality rate. Ischemic stroke has become the disease with the highest mortality and disability rate in China. Prevention is the key to the prevention of cerebrovascular disease, especially for the control of risk factors. Some traditional risk factors, such as high blood pressure, diabetes, smoking, drinking, obesity, dyslipidemia and so on, have been known for their association with cerebral infarction. Hyperhomocysteinemia is a new risk factor for cerebrovascular disease. At present, there is no conclusion on the relationship between hyperhomocysteinemia and cerebral infarction at home and abroad. Whether reducing plasma homocysteine can reduce the incidence of cerebrovascular disease is still controversial. In order to provide new clues for screening and prevention of ischemic cerebrovascular disease, the relationship between HHcy and cerebral infarction and traditional risk factors was studied in patients with cerebral infarction in Northeast China. From September 2012 to September 2013, patients with cerebral infarction in Department of Neurology, Bai Qiuen first Hospital of Jilin University, were selected as subjects. The following research was done: 1 1023 patients with cerebral infarction were divided into 5 groups according to TOAST classification. 2. The proportion of all patients with cerebral infarction with different degrees of HHcy was divided into 5 groups according to TOAST classification. To compare the difference of HHcy between groups according to whether carotid intima thickness (IMT) was thickened or not, divided into two groups: 1: IMT 鈮

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