CAJ | 학술논문

目的：研究同型半胱氨酸、叶酸、维生素 B12水平与急性脑梗死的关系。方法参照 Pullicinp 法将2011年8月至2013年12月期间接受治疗的急性脑梗死轻度、中度和重度患者各50例纳入研究的观察组，同期体检健康者50例纳入研究的对照组。检测血清中同型半胱氨酸、叶酸、维生素 B12水平，并采用美国国立卫生研究院卒中量表（NIHSS 量表）、简易精神状态评价量表（MMSE 量表）和日常生活活动能力（ADL）量表评价神经功能、认知功能以及生活能力。结果脑梗死患者的同型半胱氨酸水平高于对照组，叶酸、维生素 B12水平低于对照组，轻度、中度和重度间比较差异有统计学意义；梗死组患者 NIHSS 评分、MMSE 评分、Barthel 指数明显低于对照组，轻度、中度和重度梗死间比较差异有统计学意义，梗死面积越大，NHISS 评分、MMSE 评分、Barthel 指数越低；血清同型半胱氨酸水平与 NIHSS 评分呈正相关，与 MMSE 评分、Barthel 指数呈负相关；叶酸、维生素 B12含量与 NIHSS 评分呈负相关，与 MMSE 评分、Barthel指数呈正相关。结论急性脑梗死患者血清中同型半胱氨酸、叶酸、维生素 B12水平发生改变，且与治疗后的神经功能、认知功能以及生活能力存在良好的相关性，是判断预后情况的理想指标。
목적：연구동형반광안산、협산、유생소 B12수평여급성뇌경사적관계。방법삼조 Pullicinp 법장2011년8월지2013년12월기간접수치료적급성뇌경사경도、중도화중도환자각50례납입연구적관찰조，동기체검건강자50례납입연구적대조조。검측혈청중동형반광안산、협산、유생소 B12수평，병채용미국국립위생연구원졸중량표（NIHSS 량표）、간역정신상태평개량표（MMSE 량표）화일상생활활동능력（ADL）량표평개신경공능、인지공능이급생활능력。결과뇌경사환자적동형반광안산수평고우대조조，협산、유생소 B12수평저우대조조，경도、중도화중도간비교차이유통계학의의；경사조환자 NIHSS 평분、MMSE 평분、Barthel 지수명현저우대조조，경도、중도화중도경사간비교차이유통계학의의，경사면적월대，NHISS 평분、MMSE 평분、Barthel 지수월저；혈청동형반광안산수평여 NIHSS 평분정정상관，여 MMSE 평분、Barthel 지수정부상관；협산、유생소 B12함량여 NIHSS 평분정부상관，여 MMSE 평분、Barthel지수정정상관。결론급성뇌경사환자혈청중동형반광안산、협산、유생소 B12수평발생개변，차여치료후적신경공능、인지공능이급생활능력존재량호적상관성，시판단예후정황적이상지표。
Objective To study the relationship between homocysteine,folate,vitamin B12 levels and acute cerebral infarction. Meth-ods 50 cases of mild infarction,moderate infarction and severe infarction in our hospital from 2011 August to 2013 December were enrolled in ob-servation group and 50 cases of healthy persons underwent physical examination in our hospital were enrolled in control group. Then serum homo-cysteine,folate,vitamin B12 content were detected,nerve function,cognitive function and life ability were evaluated by NIHSS scale,MMSE scale and ADL scale. Results Patients with cerebral infarction Homocysteine levels was significantly higher than that of the control group,folic acid,vitamin B12 levels was lower than control group. There were statistically significant between mild,moderate and severe. The patients with cerebral infarction NIHSS,MMSE,Barthel was significantly lower than control group,there were statistically significant between mild,moderate and severe. The serum Hcy levels were positively correlated with NIHSS score and negatively correlated with MMSE score,Barthel index. The fo-late,vitamin B12 levels were negatively correlated with NIHSS score and positively correlated with MMSE score,Barthel index. Conclusion Ser-um homocysteine,folate,vitamin B12 content change in patients with acute cerebral infarction and are ideal index to evaluate prognosis for their levels,which have good correlation with nerve function,cognitive function and life ability.