目的 探讨血浆同型半胱氨酸（homocysteine, HCY）浓度对老年脑卒中病的临床预警价值。方法 2010-01至2012-07我院收治老年脑卒中患者143例, 分为脑梗死组和脑出血组, 并选择同期的老年健康体检者371例作为对照组, 所有受检者均于清晨空腹采取静脉血, 采用酶化学法测定HCY浓度。结果 脑梗死组患者的血浆HCY浓度显著高于健康对照组, 差异具有统计学意义（P<0.05）；脑出血组患者的HCY浓度显著高于健康对照组, 差异有统计学意义（P<0.05）。脑梗死组和脑出血组的HCY浓度相近, 差异无统计学意义（P>0.05）。结论 HCY浓度与老年脑梗死和脑出血的发生有密切联系, 检测老年人HCY浓度对脑卒中病的发生有重要的预警价值；HCY的浓度不能作为脑梗死和脑出血之间区分判定的依据。

Objective To investigate the value of plasma homocysteine (HCY) levels determination in early warning of elderly stroke disease. Methods 143 elderly stroke patients were admitted from January 2010 to July 2012. The subjects were divided into cerebral infarction and intracerebral hemorrhage groups. 371 elderly healthy subjects were recruited as the control group. Fasting venous blood samples were collected, and HCY levels were determined by enzyme chemical method. Results In both cerebral infarction and cerebral hemorrhage group of patients, plasma HCY level was significantly higher than that in the control healthy group, with significant difference (P<0.05). HCY level in cerebral infarction and intracerebral hemorrhage groups, however, showed no statistically significant difference (P>0.05). Conclusions HCY levels in aged patients with acute cerebral infarction and cerebral hemorrhage are closely linked; examination of HCY levels in aged patients may have a warning value on stroke. However, HCY level cannot distinguish cerebral infarction and cerebral hemorrhage in the clinical diagnosis.