脑梗死患者血清同型半胱氨酸与颈动脉硬化关系的研究

目的研究脑梗死患者血清同型半胱氨酸(homocysteine,Hcy)水平及其与颈动脉硬化的关系。方法收集230例脑梗死患者、180例健康对照者血液标本,采用荧光偏振免疫法测定Hcy、叶酸和维生素B12及酶法测定血脂水平。同时对165例患者作颈动脉超声检查并按动脉硬化的程度分组,比较不同程度颈动脉硬化组血清Hcy水平变化。结果脑梗死组患者血清Hcy水平显著高于对照组(P<0.05),血清Hcy与叶酸,维生素B12呈明显负相关(P<0.05),随着颈动脉病变程度加重血清Hcy水平呈上升趋势,且高Hcy检出率增高。结论高Hcy血症是脑梗死的独立危险因素,与颈动脉硬化程度有关,高血Hcy水平的主要原因可能与缺乏叶酸、维生素B12有关。

The Relationship between Serum Homocysteine and Carotid Artery Atherosclerosis in Patients with Cerebral Infarction

Objective TO Study the level of serum homocysteine in patients with cerebral infarction and relationship between homocysteine(Hcy) and carotid artery atherosclerosis.Methods Blood sample were collected from 230 patients with cerebral infarction and 180 healthy individual controls.The concentrations of Hcy,foliate and vitamin B_(12) were tested by means of fluorescence polarization immunoassay,plasma lipid was detected by enzymic method.In the meantime,all carotid arteries of 165 cases were examined with color Doppler ultrasound.The subjects were divided into 4 groups according to the severity of lesion of carotid artery.The concentration of Hcys were compared in different groups.Results The level of Hcy in the patients with cerebral infarction increased significantly as compared with the controls(P<0.05),Hcy was negatively correlated between foliate and vitamin B_(12)(P<0.05).When lesion of carotid artery became severer,serum Hcy was higher and more cases of hyperhomocysteinemia were found.Conclusions Hyperhomocysteinemia is a independent risk factor of cerebral infarction and is associated with carotid artety atherosclerosis.The cause of hyperhomocysteinemia may be associated with shortage of foliate and vitamin B_(12).