血清Hcy、FA、VitB12水平及H.pylori感染与脑梗死的相关性研究

目的：探讨脑梗死（cerebral infarction，CI）患者血清同型半胱氨酸（homocysteine，Hcy）、叶酸（folate，FA）、维生素B12（Vitamin B12，VitBl2）水平及幽门螺杆菌（H_pylori）感染与脑梗死的关系，为预防和治疗脑梗死提供参考依据。方法：选择本科收治的132例脑梗死患者和同期81例健康对照者为研究对象，检测和比较其血清同型半胱氨酸（Hey）、叶酸（FA）、VitB12水平及HP-IgG抗体。结果：（1）脑梗死患者H．pylori的感染率为50．76％，显著高于健康对照组（35．80％）（X2=0．54，P〈0．05）；（2）脑梗死患者血清Hey（20．02±8．84）μmol／L]和FA水平（14．47±6．38）ng／mL）]与健康对照组（12．36±4．97）μmol／L，（16．82±11．43）ng／mL）]比较，均具有显著差异（P〈0．01，P〈0．01）；而VitB12水平与健康对照组比较无统计学意义（P〉0．05）；（3）脑梗死患者中，HP-IgG阳性的患者Hey水平（24．20±8．81）μmol／L]明显高于HP-IgG阴性的患者（15．71±6．53）μmol／L]（P〈0．01），血清FA水平（14．59±7．54）ng／mL）]明显低于于HP-IgG阴性的患者（14．43±4．98）ng／mL]（P〈0．05），而两组之间VitBl2水平比较无明显差异（P〉0．05）；HP—IgG阳性的脑梗死患者Hey水平（24．20±8．81）bLmol／L]与HP—IgG阳性的健康对照组（13．25±5．24）μmol／L]相比，差异显著（P〈0．05），FA，VitB12水平低于健康对照组，但并无显著差异（P〉0．05）.结论：脑梗死患者H．pylori的感染率高于健康人群；H．pylori感染可能影响脑梗死患者Hey的代谢，导致Hey水平升高，促进了脑梗死的发生和发展。

Study on the Correlation of Serum Levels of Homocyst,Folate, Vitamin B 12 and Helicobacter Pylori Infections with Cerebral Infarction

Objective： To investigate the correlation of the serum levels of homocyst, folate, vitamin B 12 and H.pylori infection with cerebral Infarction, and to provide evidences for the prevention and treatment of cerebral infarction. Methods： 132 patients with cerebral Infarction and 81 health adults were selected. The serum levels of homocyst, folate, vitamin B 12 and IG antibodies to H.pylori were measured. Results： （1）The infection rate of H.pylori in cerebral Infarction patients was 50.76%, which was significantly higher than that in the health control group （35.80%） （X2=4.38, P〈0.05）; （2） Compared with the health control group （12.36± 4.97） μmol/L, （16.82± 11.43） ng/mL）], the serm levels ofhomocyst （20.02± 8.84） μmol/L] and folate （14.47± 6.38） ng/mL] in cerebral Infarction patients were both significantly different（P〈0.01,P〈0.01）; but no statistical significance of the serum level of FA had been found between the two groups （P〉0.05）; （3）Among cerebral infarction patients, the serum level ofhomocyst in HP-IgG （＋） patients （24.20± 8.81）μmol/L]was significantly higher than that in HP-IgG（-） patients（15.71 ± 6.53） p, mol/L]（P〈0.01）; the serum levels of FA（14.59± 7.54） ng/mL] was significantly lower than that in HP-IgG（-） patients （14.43 ± 4.98）ng/mL] （P〈0.05）, but the serum levels of vitamin B 12 had no differences between HP-IgG ＋and HP-IgG- groups（P〉0.05）; among HP-IgG＋patients, compared to the health control group（13.25± 5.24） μmol/L], the serm level ofhomocyst（24.20± 8.81） μmol/L] in Cerebral Infarction patients increased significantly （P〈0.05） while the serm levels of FA and VitB12 degraded; but the serum level of FA and VitB12 had no significant differences （P〉0.05）. Conclusion： The infection of H.pylori in Cerebral Infarction patients was generally higher than that in healthy crowd; the infection of H.pylori might effect to the metabolism of homocyst, thus resulted in the high level of homocyst and the development of pathological changes in Cerebral Infarction patients.