高同型半胱氨酸血症与颈动脉粥样硬化对老年急性脑梗死影响的研究

目的：探讨老年急性脑梗死患者血清同型半胱氨酸（Hcy）水平与颈动脉硬化（CAA）程度之间的关系。方法：对80例老年急性脑梗死患者进行空腹血浆Hcy、空腹血糖、胆固醇、甘油三酯、叶酸、维生素B12（VitB12）水平的测定,并且进行彩超检查颈动脉内膜-中层厚度（IMT）、斑块大小、狭窄程度及血流速度的检测,按照颈动脉狭窄程度及IMT值分为A、B、C、D四组;对Hcy水平与叶酸、VitB12及其他相关因素进行分析。结果：（1）随着CAA程度的加重,Hcy水平升高,A、B、C组和D组之间比较差异均有统计学意义（P〈0.05）;（2）叶酸与VitB12的水平随着CAA程度的加重而降低,仅在A组和D组之间比较差异有统计学意义（P〈0.05）;（3）统计学分析表明血清Hcy水平与血叶酸和VitB12水平负相关（r=-0.328、-0.442,P〈0.05）。结论：高Hcy血症与颈动脉粥样硬化程度密切相关,是脑梗死发生的独立危险因素。

The Research on High Homocysteine Levels and Carotid Atherosclerosis in Elderly with Acute Cerebral Infarction

Objective： To analyze the relationship between the homocysteine（Hcy）and carotid artery atherosclerosis（CAA）degree on the old acute cerebral infarction.Method： 80 patients with cerebral infarction were selected, plasma Hcy, fasting blood-glucose, cholesterol, triglyceride, folate and VitB12 of all subjects were measured; the intima-media thickness（IMT） of artery, patch size, degree of stenosis and blood flow velocity were detected. The patients were divided into A, B, C, D four groups according to the degree of carotid stenosis and IMT values. The Hcy levels and folic acid, VitB12 and other related factors were analyzed. Result：（1） The level of Hcy increased with aggravation of CAA, there were significant differences among A, B, C group and D group（P〈0.05）;（2）the level of VitB12 and folate decreased while Hcy level increased, and only the difference between A and D group was obviously（P〈0.05）;（3） levels of plasma Hcy were negatively correlated with VitBl2 and folic acid levels（r=-0.328,-0.442, P〈0.05）.Conclusion： Hyperhomocysteinemia is an important risk factor for cerebral infarction, plasma homocysteine is graded associated with carotid atherosclerosis.