摘要目的:分析血清同型半胱氨酸(Hcy)水平与老年脑出血患者血肿吸收及认知功能的相关性。方法:回顾性分析我院2017年1月至2019年7月收治的老年脑出血患者80例临床完整资料，根据患者血清Hcy检测水平(正常范围为<15 μmol/L)将血清Hcy<15 μmol/L患者21例纳入A组，将血清Hcy≥15 μmol/L患者59例纳入B组，详细记录并比较两组患者一般资料(性别、年龄、高血压病史、糖尿病病史、出血部位、出血量等)、血肿吸收及认知功能等情况，经Spearman相关性分析血清Hcy水平与老年脑出血患者血肿吸收、认知功能的相关性。结果:两组患者性别、年龄、高血压病史、糖尿病病史、出血部位及出血量比较差异均无统计学意义；A组21例患者血肿吸收速度为(0.4±0.1)ml/d、MoCA评分(19.6±4.6)分，均高于B组59例患者(0.3±0.1)ml/d、(16.3±3.3)分( t＝3.935、3.532，均 P＝0.000)；Spearman相关性分析结果显示，血清Hcy水平与老年脑出血患者血肿吸收及认知功能呈负相关( r＝－0.372、－0.311， P＝0.000、0.005)，即血清Hcy水平越高，老年脑出血患者血肿吸收以及认知功能情况越差。 结论:老年脑血出患者发病时血清Hcy会发生变化，随着血清Hcy水平不断增加，患者血肿吸收慢及认知功能改善差等不良风险随之上升，故血清Hcy水平在老年脑出血患者疾病发生、发展中起重要作用，可用于评价脑出血患者的病情及预后情况。

abstractsObjective:To analyze the correlation of serum homocysteine(Hcy)levels with hematoma absorption and cognitive function in elderly patients with cerebral hemorrhage.Methods:Clinical data of 80 elderly patients with cerebral hemorrhage admitted to our hospital from January 2017 to July 2019 were retrospectively analyzed.According to serum levels of Hcy(normal range: <15 μmol/L), 21 patients with serum Hcy<15 μmol/L were included in Group A, and 59 patients with Hcy≥15 μmol/L were included in Group B. General data(gender, age, hypertension, diabetes, bleeding part, bleeding volume, etc.), hematoma absorption and cognitive function were recorded and compared between the two groups.The correlation of serum Hcy levels with hematoma absorption and cognitive function in elderly patients with cerebral hemorrhage was analyzed by using Spearman correlation analysis.Results:There was no statistical difference in gender, age, hypertension, diabetes, bleeding location and bleeding volume between the two groups.The speed of hematoma absorption and scores of Montreal Cognitive Assessment(MoCA)were higher in Group A than in Group B[(0.4±0.1)ml/d vs.(0.3±0.1)ml/d, (19.6±4.6)points vs.(16.3±3.3)points, t=3.935 and 3.532, both P=0.000]. Spearman correlation analysis showed that serum Hcy level was negatively correlated with hematoma absorption and cognitive function in elderly patients with cerebral hemorrhage( r=-0.372 and-0.311, P=0.000 and 0.005), indicating that hematoma absorption and cognitive function were worse with the higher serum Hcy levels in elderly patients with cerebral hemorrhage. Conclusions:Serum Hcy levels change in elderly patients with cerebral hemorrhage.As serum Hcy levels increase, the risk for adverse events such as slow hematoma absorption and unsatisfactory improvement in cognitive function in patients increases accordingly.Serum Hcy levels play an important role in the occurrence and development of diseases in elderly patients with cerebral hemorrhage and can be used to evaluate the condition and prognosis of patients with cerebral hemorrhage.