CAJ | 학술논문

目的：探讨高同型半胱氨酸血症（HHcy）与缺血性脑血管病危险因素的关系及干预治疗。方法选择265例急性缺血性脑血管病患者（其中腔隙性脑梗死85例，短暂性脑缺血发作53例，急性脑梗死127例）和140例对照，检测所有受试者空腹血浆同型半胱氨酸（Hcy）水平并与其它缺血性脑血管病危险因素进行比较。分析HHcy伴有传统危险因素时对缺血性脑血管病的影响，并进一步提出干预治疗措施及预后。结果 HHcy合并高血压病、糖尿病危险因素者可促使缺血性脑血管病的发生（P＜0．01）。使用单一维生素治疗6周无效（P＞0．05），联合使用两种维生素治疗4～6周起效（P＜0．05），但尚未达标，联合使用三种维生素治疗2周开始起效（P＜0．05），4～6周达标，且随访观察1．5年，三种维生素治疗组再发缺血性脑血管病明显减少。结论 HHcy可能与缺血性脑血管病其它危险因素如高血压、糖尿病相互作用促进缺血性脑血管病的发生有关。三种维生素干预治疗4～6周，效果及预后明显优于未服维生素治疗组、一种或两种维生素治疗组。
목적：탐토고동형반광안산혈증（HHcy）여결혈성뇌혈관병위험인소적관계급간예치료。방법선택265례급성결혈성뇌혈관병환자（기중강극성뇌경사85례，단잠성뇌결혈발작53례，급성뇌경사127례）화140례대조，검측소유수시자공복혈장동형반광안산（Hcy）수평병여기타결혈성뇌혈관병위험인소진행비교。분석HHcy반유전통위험인소시대결혈성뇌혈관병적영향，병진일보제출간예치료조시급예후。결과 HHcy합병고혈압병、당뇨병위험인소자가촉사결혈성뇌혈관병적발생（P＜0．01）。사용단일유생소치료6주무효（P＞0．05），연합사용량충유생소치료4～6주기효（P＜0．05），단상미체표，연합사용삼충유생소치료2주개시기효（P＜0．05），4～6주체표，차수방관찰1．5년，삼충유생소치료조재발결혈성뇌혈관병명현감소。결론 HHcy가능여결혈성뇌혈관병기타위험인소여고혈압、당뇨병상호작용촉진결혈성뇌혈관병적발생유관。삼충유생소간예치료4～6주，효과급예후명현우우미복유생소치료조、일충혹량충유생소치료조。
Objective To study the relationship between hyperhomocysteinemia(HHcy)and risk factors of ischemic cerebrovascular diseases and intervention therapy.Methods Two hundred and sixty-five patients with acute ischemic cerebrovascular diseases (85 pa-tients with lacunar infarction,53 patients with transient ischemic attack,127 patients with acute cerebral infarction)and 140 control ca-ses were chosen.Plasm homocysteine(Hcy)levels with empty stomach were examined in all subjects and compared with other risk fac-tors of ischemic cerebrovascular diseases.The effect of HHcy accompanied by conventional risk factors on ischemic cerebrovascular dis-eases was analyzed.Intervention therapy and prognosis were introduced.Results HHcy accompanied by hypertensive disease or diabe-tes increased the occurrence of ischemic cerebrovascular diseases (P<0.01).Single vitamin therapy for 6 weeks was inefficient (P>0.05).Allied two vitamin therapy for 4 to 6 weeks was effective (P<0.05),but wasn’t up to standard.Allied three vitamin therapy for 2 weeks was effective (P<0.05),and was up to standard after 4 to 6 weeks.The patients of allied three vitamin therapy decreased the recurrence of ischemic cerebrovascular diseases after a follow-up of 1 .5 years.Conclusions HHcy can interact with risk factors of ischemic cerebrovascular diseases such as hypertensive disease or diabetes and promote the development of ischemic cerebrovascular diseases.The effect of intervention therapy with three vitamins is prominent compared with no vitamin therapy,single vitamin therapy and two vitamin therapy.