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目的 探讨脑梗死急性期患者血浆中脂蛋白a(Lpa)和同型半胱氨酸(Hcy)水平与病情和神经功能缺损程度的相关性.方法 选取急性脑梗死患者62例作为梗死组,根据发生脑梗死的面积将梗死组患者分为小梗死组、中梗死组和大梗死组;同时按NIHSS评分将梗死组患者分为轻型组、中型组和重型组.选择我院同期健康体检的健康人群55例作为对照组.检测研究对象血浆中Lpa和Hcy含量,采用Spearman等级相关进行相关分析.结果 与对照组比较,梗死组患者血浆中Lpa和Hcy水平均增加,差异均有统计学意义(t=2.53、3.06,P＜0.05);小梗死组、中梗死组和大梗死组三组患者之间血浆中Lpa和Hcy水平,差异均有统计学意义(F=5.84、7.93,P＜0.05),与小梗死比较,中梗死组和大梗死组患者血浆中Lpa和Hcy水平均增加,差异均有统计学意义(t=5.84、9.64、4.93、7.46,P＜0.05);与中梗死组比较,大梗死组患者血浆中Lpa和Hcy水平均增加,差异均有统计学意义(t=3.75、2.81,P＜0.05);轻型组、中型组和重型组三患者血浆中 Lpa和Hcy水平均差异均有统计学意义(F=7.92、5.31,P＜0.05),与轻型组比较,中型组和重型组患者血浆中Lpa和Hcy水平均增加,差异均有统计学意义(t=7.92、11.43、5.31、10.32,P＜0.05);与中型组比较,重型组患者血浆中Lpa和Hcy水平均增加,差异均有统计学意义(t=2.18、3.35,P＜0.05);脑梗死患者血浆中 Lpa和Hcy水平与病情和神经功能缺损程度呈正相关(r=0.450、0.467、0.450、0.467).结论 脑梗死急性期患者血浆中Lpa和Hcy水平显著升高,且与脑梗死急性期患者的病情和神经功能缺损程度呈正相关,检测血浆中Lpa和Hcy水平能够有效判断脑梗死患者病情.“,”Objective To investigate the plasma levels of lipoprotein a (Lpa) and homocysteine (Hcy) in patients with acute cerebral infarction and its correlation with severity of neurological deficits.Methods Sixtytwo patients with acute cerebral infarction hospitalized in author′s hospital from October 2015 to October 2017 were selected as infarct group.And the infarction group was further divided into small-size infarcts group,middle-size infarcts group and large-size infarcts group according to the area of cerebral infarction. Then according to the NIHSS score,patients were divided into mild group,moderate group and severe group. Fifty-five healthy individuals were selected as the control group.The plasma levels of Lpa and Hcy were measured by automatic biochemical analyzer.Correlation analysis was used by Spearman level correlation.Results The plasma levels of Lpa and Hcy in the infarct group were higher than those in the control group (t=2.53,3.06,P＜0.05).Compared with the small-size infarct group,the plasma levels of Lpa and Hcy in the middle-size and large-size infarct groups were increased,and the differences were statistically significant (t=5.84,9.64,4.93,7.46,P＜0.05).Compared with the middle-size infarction group,the plasma levels of Lpa and Hcy in the large-size infarction were increased (t=3.75,2.81,P＜0.05).Compared with the mild group, the plasma levels of Lpa and Hcy in the moderate and severe groups were increased,and the differences were statistically significant (t=7.92,11.43,5.31,10.32,P＜0.05).Compared with the moderate group,the levels of Lpa and Hcy in the severe group were increased,the difference was statistically significant (t=2.18,3.35, P＜0.05).The plasma levels of Lpa and Hcy were positively correlated with the severity and degree of neurological deficits (r=0.450,0.467;r=0.450,0.467).Conclusion The plasma levels of Lpa and Hcy in patients with acute cerebral infarction are significantly increased,and they are positively correlated with the severity and degree of neurological deficits.The detection of plasma levels of Lpa and Hcy can effectively determine the condition of patients with cerebral infarction.