血清同型半胱氨酸水平与颈动脉粥样硬化及脑梗死关系的临床研究

目的探讨血清同型半胱氨酸(Hcy)检测及颈动脉粥样硬化在急性脑梗死中的临床意义。方法对180例脑梗死患者与130例健康对照者进行空腹血浆Hcy水平的测定、彩色多普勒超声检查颈动脉硬化程度,比较两组的血浆Hcy浓度及颈动脉粥样硬化程度的差异。结果脑梗死组血浆中Hcy浓度(25.1±4.9)μmol/L明显高于而对照组(14.8±4.1)μmol/L,差异有统计学意义(P<0.05)。脑梗死组中颈动脉硬化发生率86.1%,高于对照组的26.1%(P<0.05)。脑梗死组中有颈动脉硬化的患者其血浆Hcy浓度为(31.3±4.8)μmol/L,高于无颈动脉硬化患者的血浆Hcy浓度(18.2±5.9)μmol/L(P<0.05)。结论高同型半胱氨酸血症与颈动脉粥样硬化及斑块形成有关,为脑梗死危险因素。

Clinical study on relationship between plasma level of homocysteine and carotid atherosclerosis in patients with acute cerebral infarction.

Objective To explore the relationship between plasma level of homocysteine and carotid atberosclerosis in patients with acute cerebral infarction. Methods A total of 180 patients with cerebral infarction（CI） and 130 healthy persons as control group were selected for this study. Plasma levels of homocysteine （Hcy）were measured, and carotid atherosclerosis in carotid artery was assessed by color Doppler ultrasound. Results Plasma levels of Hcy in CI group and control group were 25.1±4.9 μmol/L and 14.8± 4.1 μmol/L respectively. The incidence rate of carotid atheroscleresis in patients of CI group was 86.1%, and that in patients of control group was 26.1%. Plasma level of Hcy and incidence rate of carotid atherosclerosis in CI group were significantly higher than those of control group（ P 〈0.05 ）. In addition, plasma level of Hcy in pa- tients of CI group with carotid atherosclemsis was also significantly higher than that of patients without carotid atherosclerosis（31.3 ±4.8 μmol/L vs. 18.2 ± 5.9 μmol/L, respectively） （ P 〈 0.05 ）. Conclusion Hyperhomocysteinemia is related to the formation of atheromatous plaque and atherosclemsis in carotid artery, and they are the risk factors of cerebral infarction.