Reis R P, Azinheira J, Reis H P, Pereira M, Baptista A, Crespo M, Pina J E, Ferreira N C, Luís A S
Serviço de Medicina, Hospital S. Francisco Xavier, Lisboa.
Acta Med Port. 1994 May;7(5):285-9.
To determine whether hyperhomocysteinemia represents a risk factor of early thrombotic cerebrovascular disease.
In a group of patients under 55 years of age (n = 33, 19 males) which had suffered a stroke from 3 months to 1 year before the study, defined by clinical criteria and presence of cerebral infarction confirmed by tomography, without history or predisposition to embolic disease. The patients were matched with a group of normal controls of checkup program, in terms of age, and sex. Patients and controls with a history of alcoholism, clinical or laboratory signs of renal or hepatic insufficiency or with a history of recent ingestion of Group B vitamins were excluded since these conditions would influence homocysteinemia levels. We measured the plasmatic basal homocysteinemia of patients and controls (HC) and 6 hours later a methionine overload of 0.1 g/Kg body weight (LOAD HC).
Patients; Controls; Signific.; Age 46.0 +/- 7.7; 45.9 +/- 7.8; NS; Basal HC. 10.1 +/- 3.4; 8.5 +/- 1.7; p < 0.05; Load HC 28.0 +/- 7.6; 22.7 +/- 5.5; p < 0.01.
In this study hyperhomocysteinemia appears as a risk factor for thrombotic cerebrovascular disease before the age of 55;-The measurement of homocysteinemia after the methionine loading test was more discriminative than the basal measurement;-A larger number of patients and controls will be necessary to establish the relative importance of homocysteinemia among other vascular risk factors in cerebrovascular disease.
确定高同型半胱氨酸血症是否为早期血栓性脑血管疾病的危险因素。
选取一组55岁以下的患者（n = 33，男性19例），这些患者在研究前3个月至1年发生过中风，根据临床标准及断层扫描证实的脑梗死确诊，无栓塞性疾病病史或易患因素。患者在年龄和性别方面与一组体检项目的正常对照组进行匹配。排除有酗酒史、肾脏或肝脏功能不全的临床或实验室体征或近期摄入B族维生素病史的患者及对照组，因为这些情况会影响同型半胱氨酸血症水平。我们测量了患者和对照组的血浆基础同型半胱氨酸血症（HC），6小时后给予0.1 g/Kg体重的蛋氨酸负荷（负荷HC）。
患者；对照组；显著性；年龄46.0±7.7；45.9±7.8；无显著性差异；基础HC 10.1±3.4；8.5±1.7；p<0.05；负荷HC 28.0±7.6；22.7±5.5；p<0.01。
在本研究中，高同型半胱氨酸血症似乎是55岁前血栓性脑血管疾病的危险因素；蛋氨酸负荷试验后同型半胱氨酸血症的测量比基础测量更具鉴别性；需要更多的患者和对照组来确定同型半胱氨酸血症在脑血管疾病其他血管危险因素中的相对重要性。
