血浆同型半胱氨酸与动脉粥样硬化及脑梗死的相关性分析

目的探讨血浆同型半胱氨酸水平与动脉粥样硬化及脑梗死的关系。方法选114例动脉粥样硬化性脑梗死患者为脑梗死组，同期选择年龄性别相匹配的健康体检者51例为对照组。根据颈动脉多普勒彩色超声检查结果将脑梗死组分为脑梗死有斑块组和脑梗死无斑块组，将对照组分为对照有斑块组和对照无斑块组；脑梗死有斑块组和对照有斑块组合称斑块组，脑梗死无斑块组和对照无斑块组合称无斑块组。所有研究对象均测定血浆同型半胱氨酸（homocysteine，HCY）水平，应用颈动脉多普勒彩色超声检查患者颈动脉内膜中层厚度（intimal-medial wall thickness，IMT）。结果动脉粥样硬化性脑梗死患者血浆同型半胱氨酸、颈动脉内膜中层厚度均较对照组增高，差异有统计学意义（P〈0.05）；斑块组血浆Hcy、IMT水平均高于无斑块组，且有统计学差异（P〈0.05）；脑梗死有斑块组血浆Hcy、IMT水平高于对照有斑块组，脑梗死无斑块组血浆Hcy、IMT水平高于对照组有斑块组，但均无统计学差异（P〉0.05）；直线相关分析显示血浆Hcy水平与IMT呈正相关（r=0．70，P＜0.05）。结论血浆HCY水平与动脉粥样硬化关系密切，可能是动脉粥样硬化的危险因素，但与脑梗死关系不明确。

The relationship among plasma homoeysteine,atherosclerosis and cerebral infarction

Objective To investigate the relationship among plasma homocysteine（HCY）, atherosclerosis and cerebral infarction. Methods One hundred and forteen patients were chosen for the cerebral infarction （CI） group and fifty-one healthy people for the control group. According to the results of carotid Doppler ultrasongraphy, these patients were redivided into two subgroups： CI with carotid atherosclerotic plaque and CI without plaque,and the controls were also redivided into two subgroups： control with carotid atherosclerotic plaque and control without plaque. The CI with carotid atherosclerotic plaque and the control with carotid atherosclerotic plaque were called plaque group, The CI without carotid atherosclerotic plaque and the control without carotid atherosclerotic plaque were called non-plaque groups. The levels of plasma HCY were measured. All groups were examined the changes of carotid intimal-medial thickness （IMT） by carotid duplex ultrasonography scanning. Results The plasma level of homocysteine was significantly higher in the atherothrombotic cerebral infarction than that in the control group （p〈0.05） ; The plasma level of homocysteine was significantly higher in plaque group than that in non-plaque group （P〈0.05）; The plasma level of homocysteine was higher in the CI with carotid atherosclerotic plaque group than that in the control with plaque group （P〉0. 05）; The plasma level of homocysteine was higher in the CI without carotid atherosclerotic plaque group than that in the control without plaque group （P〉0.05）; The levels of Hcy were correlated with the IMT（P〈0.05）. Conclusions Plasma Hcy level has a close corelation with carotid atheroseterotic plaque, between Hcy and High level of Hcy may be the risk factor of carotid atherosclerotic , but the relation with cerebral infarction was still not clear.