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目的了解脑梗死的危险因素同型半胱氨酸(Hcy)及糖化血红蛋白(HbA1c)对脑梗死TOAST及OCSP分型的影响。方法将392例急性脑梗死按血清Hcy及HbA1c水平分为四组:两者均正常组(A组),单纯高Hcy组(B组),单纯高HbA1c组(C组),两者均高组(D组),将其临床基线资料进行回顾性分析,并分析与TOAST和OCSP分型的关系及测定对梗死面积大小的影响。结果 C、D组中FBG、TG及HbA1c均高于A组,其中C、D组中TG也高于B组,差异均有统计学意义(P<0.05);TOAST分型各组亚型之间无统计学差异(P>0.05),C组及D组OCSP分型中的后循环梗死比例较A组高(P<0.05);B组中面积脑梗死患者比例高于A组(P<0.05),C组中小面积脑梗死患者比例高于B组(P<0.05)。结论单纯高Hcy血症脑梗死患者,梗死面积较大,单纯高HbA1c患者倾向于小面积梗死,且多数为后循环脑梗死。
Objective To investigate the effect of homocysteine (Hcy) and glycosylated hemoglobin (HbA1c) on the types of TOAST and OCSP after cerebral infarction. Methods 392 cases of acute cerebral infarction were divided into four groups according to serum Hcy and HbA1c levels: normal control group (group A), simple high Hcy group (group B) and simple high HbA1c group (group C) Group D (Group D). The clinical baseline data were retrospectively analyzed. The relationship between TOAST and OCSP typing and the effect on infarct size were analyzed. Results The FBG, TG and HbA1c in group C and D were higher than those in group A, and the TG in group C and D was also higher than that in group B (P <0.05). The subtypes of TOAST There was no significant difference between the two groups (P> 0.05). The proportion of posterior circulation infarction in group C and group D was higher than that in group A (P <0.05), and the proportion of group B with middle cerebral artery infarction was higher than that in group A (P < 0.05). The proportion of small area cerebral infarction in group C was higher than that in group B (P <0.05). Conclusions In patients with hyperhomocysteinemia alone, the area of infarction is larger. Patients with high HbA1c tend to have small infarcts, and most of them are posterior circulation cerebral infarction.