急性脑梗死患者血浆同型半胱氨酸水平与颈动脉粥样硬化关系的临床研究

目的 研究急性脑梗死患者血浆同型半胱氨酸(Hcy)水平与颈动脉粥样硬化的关系,对其发病机制进行初步探讨.方法 入选103例首次发病的急性脑梗死患者和46例健康体检者,应用颈动脉多普勒彩色超声检测颈动脉内膜中层厚度(IMT).用免疫比浊法测定血浆Hcy,并对检测结果进行统计学分析.结果 急性脑梗死组血浆Hcy水平明显高于对照组[(18.21±0.51) μmol/L比(12.32±0.16) μmol/L,P＜0.01]；脑梗死内膜增厚组、斑块组血浆Hcy明显高于无斑块组[(18.37 ±0.24)、(20.16±0.58) μmol/L比(13.25±0.13) μmol/L,P＜0.05]；斑块组血浆Hcy水平明显高于内膜增厚组(P＜0.05).直线相关分析显示血浆Hcy水平与IMT呈正相关(r=0.68,P＜0.01).结论 血浆Hcy水平与急性脑梗死患者动脉粥样硬化程度密切相关,对高Hcy脑梗死患者进行干预是一种值得研究的防治手段.

Relationship between carotid atherosclerosis and plasma homocysteine level in patients with acute cerebral infarction

Objective To investigate the relation between the serum homocysteine level in patients with a- cute cerebral infarction and carotid artery atheroselerosis. Methods In 103 patients with initial acute cerebral in- farction and 46 healthy persons, carotid intima-medial wall thickness（IMT） was determined with colored doppler ul- trasound; serum homocysteine level was determined with immnnoturbidimetry. Results The serum homoeysteine level in the patient group was significantly higher than that in control group[ （ 18.21 ±0.51 ） μmol/L vs （ 12.32 ± 0.16） μmol/L, P 〈 0.01 ]. The serum homocysteine level in the patients with carotid artery intima media thickness oratheromatous plaque was significantly higher than that in the patients without atheromatous plaque [ （ 18.37 ± 0.24 ）, （ 20.16 ± 0.58 ） μmol/L vs （ 13.25 ±0.13 ） μmol/L, P 〈 0.05 ]. The serum homocysteine level of patients with atheromatous plaque was significantly higher than that of patients with carotid artery intima media thickness（P 〈 0.05 ） ; the serum homocysteine level was positively correlated with intimal-medial wall thickness （ r = 0.68, P 〈 0.01 ）. Conclusion The serum homocysteine level is significantly correlated with the degree of atherosclerosis of patients with acute cerebral infarction.