腔隙性脑梗死患者血浆 tH cy 水平与 CVHS 的相关性分析

摘要

Objective To investigate the value of plasma total homocysteine ( tHcy) in diagnosis of lacunar infarc-tion, and the relationship with cerebrovascular hemodynamic accumulative score (CVHS).Methods Ninety cases of pa-tients with acute lacunar infarction were selected .According to the tHcy levels , the patients were divided into high tHcy group (tHcy≥10.0 μmol/L, 66 cases) and normal tHcy group (tHcy <10.0 μmol/L, 24 cases).The cerebrovascular hemodynamic parameters ( CVHP) of bilateral carotid artery were measured by using cerebral blood vessel analyzer , and CVHS was calculated .The correlation between tHcy and CVHS was analyzed .Results The values of Vmax , Vmin, Vmean, Qmean and CVHS in the high tHcy group were lower than those of the normal tHcy group , and the peripheral re-sistance (Rv), dynamic resistance (DR), critical pressure (CP), pulse wave velocity (Wv), characteristic impedance (Zcv), divergence rate (DI) and differential pressure (DP) were higher than those of the normal tHcy group (all P<0.05).The plasma tHcy level was negatively correlated with CVHS in the high tHcy group (r=-0.440, P<0.05), and no significant correlation between them was found in the normal tHcy group .Conclusion The plasma tHcy level was nega-tively correlated with CVHS in patients with high tHcy , and the elevated plasma tHcy levels may be related with the cere-bral vascular dysfunction in patients with lacunar infarction .%目的：探讨血浆总同型半胱氨酸（tHcy）水平在腔隙性脑梗死病情判断中的价值，并分析其与脑血流动力学积分（CVHS）的关系。方法90例急性腔隙性脑梗死患者，入院时血浆tHcy水平≥10．0μmol／L者66例（高tHcy组）、＜10．0μmol／L者24例（正常tHcy组）。采用脑血管功能检测仪检测两组脑血流动力学指标（CVHP），计算脑血流动力学积分（ CVHS）。分析血浆tHcy水平与CVHS的相关性。结果高tHcy组最大流速（ Vmax ）、最小流速（Vmin）、平均流速（Vmean）、平均流量（Qmean）、CVHS均低于正常tHcy组，外周阻力（Rv）、动态阻力（DR）、临界压力（CP）、脉搏波速（Wv）、特性阻抗（Zcv）、可扩张度（DI）和舒张压与临界压的差值均高于正常tHcy组（P均＜0．05）。高tHcy组血浆tHcy水平与CVHS呈负相关（r＝－0．440，P＜0．05），正常tHcy组血浆tHcy水平与CVHS无明显相关性。结论高tHcy水平患者血浆tHcy水平与CVHS呈负相关，高tHcy水平可能与腔隙性脑梗死患者脑血管功能异常有关。