微创医学

【摘要】目的探讨急性脑梗死患者介入治疗前后血清同型半胱氨酸（Hcy）及血浆血栓素B2（TXB2）、6-酮前列腺素F1α（6-K-PGF1α）检测的临床价值。方法选取接受介入治疗的 45例急性脑梗死患者作为观察组，按1 ∶1比例选取同期进行健康体检的45例非脑梗死人群作为对照组。比较对照组及观察组患者治疗前后、不同梗死面积患者血清Hcy和血浆TXB2、6-K-PGF1α水平差异。结果治疗前，观察组患者的血清Hcy及血浆TXB2、6-K-PGF1α水平均高于对照组（均P＜0.05）；观察组大面积梗死、中面积梗死、小面积梗死患者的血清Hcy、血浆TXB2水平依次降低（均P＜0.05）；但不同梗死面积患者的血浆6-K-PGF1α水平比较，差异无统计学意义（P＞0.05）。预后良好组患者血清Hcy和血浆TXB2、6-K-PGF1α水平明显低于治疗前和预后不良组（均P＜0.05）；而预后不良组患者血清Hcy和血浆TXB2、6-K-PGF1α水平与治疗前比较，差异均无统计学意义（均P＞0.05）。观察组患者血清Hcy水平与血浆TXB2、6-K-PGF1α水平呈正相关（r=0.518，P＜0.05；r=0.601，P＜0.05）；血清Hcy及血浆TXB2、6-K-PGF1α水平与脑梗死面积呈正相关（r=0.412，P＜0.05；r=0.557，P＜0.05；r=0.349，P＜0.05）。结论急性脑梗死患者治疗前血清Hcy和血浆TXB2、6-K-PGF1α水平均较非脑梗死人群高，且其水平随病情加重而升高，检测血清Hcy和血浆TXB2、6-K-PGF1α水平对于了解患者病情及预后有重要的临床意义。

【Abstract】 ObjectiveTo investigate the clinical value of serum homocysteine (Hcy), plasma thromboxane B2 (TXB2) and 6-keto prostaglandin F1α (6-K-PGF1α) detection in patients with acute cerebral infarction before and after interventional therapy. MethodsA total of 45 patients with acute cerebral infarction who received interventional therapy were selected as the observation group, and 45 people with non-cerebral infarction who underwent physical examination at the same period were selected as the control group according to the ratio of 1 ∶1. The levels of serum Hcy and plasma TXB2, 6-K-PGF1α were compared between the control group and the observation group before and after treatment, and in patients with different infarct areas. ResultsBefore treatment, the levels of serum Hcy and plasma TXB2, 6-K-PGF1α in the observation group were higher than those in the control group (all P＜0.05). The levels of serum Hcy and plasma TXB2 in patients with large area infarction, medium area infarction, and small area infarction in the observation group decreased sequentially (all P＜0.05). However, there was no statistically significant difference in the level of plasma 6-K-PGF1α in patients with different infarct areas (P＞0.05). The levels of serum Hcy and plasma TXB2, 6-K-PGF1α in patients with good prognosis were significantly lower than those before treatment and those in patients with poor prognosis (all P＜0.05). However, there were no statistically significant differences in the levels of serum Hcy and plasma TXB2, 6-K-PGF1α before and after treatment in the poor prognosis group (all P＞0.05). The level of serum Hcy in the observation group was positively correlated with the levels of plasma TXB2 and 6-K-PGF1α (r=0.518, P＜0.05; r=0.601, P＜0.05); and the levels of serum Hcy and plasma TXB2, 6-K-PGF1α were positively correlated with cerebral infarction area (r=0.412, P＜0.05; r=0.557, P＜0.05; r=0.349, P＜0.05). ConclusionThe levels of serum Hcy and plasma TXB2, 6-K-PGF1α in patients with acute cerebral infarction before treatment were higher than those in non-cerebral infarction population, and their levels increased with the aggravation of the disease. The detection of serum Hcy and plasma TXB2, 6-K-PGF1α levels has important clinical significance for understanding the condition and prognosis of patients.