血浆同型半胱氨酸、超敏C反应蛋白与脑部大动脉粥样硬化性狭窄的相关性

目的探讨血浆总同型半胱氨酸（homocysteine，Hcy）、超敏C反应蛋白（high-sensitivity C-reactive protein，hs-CRP）水平与脑大动脉粥样硬化性（atherosclerosis，AS）狭窄的关系。方法对行数字减影全脑血管造影（digital subtraction angiography，DSA）的94例缺血性脑血管病患者进行分组，其中具有颅内外大动脉粥样硬化性狭窄（至少1支血管狭窄率〉50％）的68例患者为狭窄组，无狭窄或轻度狭窄（狭窄率≤50％）患者26例为对照组。对两组患者血浆总Hcy水平、hs-CRP及脑卒中的常规危险因素如年龄、性别、高血压、糖尿病、长期吸烟、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）水平等进行了分析。结果狭窄组血浆Hcy及hsCRP水平及升高的比例明显大于对照组；多元回归分析显示Hcy、hsCRP、高血压、糖尿病、吸烟与脑大动脉狭窄密切相关；血浆Hcy及hsCRP随大动脉硬化性狭窄程度加重而增高。结论血浆Hcy及hs-CRP水平升高与脑部动脉粥样硬化性狭窄密切相关，是脑大动脉粥样硬化性狭窄病变形成的危险因子。

Correlations Among Plasma Level of Homocysteine,High-sensitivity C-Reactive Protein and Cerebral Large-Artery Atherosclerosis

Objective To investigate the relationship among plasma homocysteine（Hcy） and high - sensitivity C -reactive protein（hsCRP） and cerebral large -artery atherosclerotic stenosis. Methods 94 adult patients with ischemic cerebrovascular disease experienced digital subtraction angiography（DSA） were enrolled, and 68 patients with potential large - artery atherosclerotic stenosis （ grade 〉 50%, at least one vessel） and 26 patients without stenosis or mild grade （ grade ≤ 50%） were included as control. Plasma Hcy and hsCRP level were analyzed and conventional risk factors of cerebral stroke such as sex, age, hypertension, diabetes, long-smoking, and plasma levels of triglyceride, high-density lipoprotein, low-density lipoprotein were evaluated in all subjects. Results Both plasma concentration of Hcy and hsCRP and the proportion of subjects with high level of Hcy and hsCRP were significantly higher in patients with potential atherosclerotic stenosis than control. Based on multivariable stepwise logistic regression model, Hcy, hsCRP, hypertension, diabetes, long-smoking were closely related to large - artery atherosclerotic stenosis. The severer the large- artery atherosclerotic stenosis is, the higher Hcy and hsCRP concentration in the blood. Conclusion High level of plasma homocysteine and high - sensitivity C - reactive protein are closely related to cerebral large - artery atherosclerosis. High concentrations of Hcy and hsCRP are risk factors of cerebral large - artery athero- sclerotic stenosis.