目的 探讨高同型半胱氨酸血症对中老年人颈总动脉狭窄的影响.方法 选取北京市某社区年龄在45 ～ 75岁的190例中老年人为研究对象,根据其血浆同型半胱氨酸水平分为高同型半胱氨酸组(同型半胱氨酸＞ 15 μmol/L,79例)和同型半胱氨酸正常组(同型半胱氨酸6～ 15μmol/L,111例),通过颈部血管超声检查,观察并比较2组颈总动脉狭窄程度.结果 190例患者中同型半胱氨酸升高的比例为41.6％(79/190),高同型半胱氨酸组平均年龄及男性受试者比例高于同型半胱氨酸正常组,差异均有统计学意义[(56±10)岁比(52±8)岁,t=-0.31,P＜0.01;74.7％ (59/79)比33.3％(37/111),x2 =31.57,P＜0.01].同型半胱氨酸正常组轻度狭窄29例(26.1％)、中度狭窄5例(4.5％)、重度狭窄或闭塞4例(3.6％);高同型半胱氨酸组分别为31例(39.2％)、17例(21.5％)、7例(8.9％),高同型半胱氨酸组颈总动脉中重度狭窄或闭塞的比例明显多于同型半胱氨酸正常组,差异有统计学意义[24例(30.4％)比9例(8.1％),x2 =27.98,P＜0.01].结论 同型半胱氨酸水平与中老年人颈总动脉狭窄的严重程度相关.%Objective To explore the effect of serum hyperhomocysteinemia on common carotid artery stenosis in middle and old aged people.Methods A total of 190 middle and old aged persons from a community in Beijing city from 45 to 75 years old were collected in this study.According to the serum level of homocysteine (Hcy),volunteers were divided into high Hcy group and Hcy normal group.The degree of common carotid artery stenosis in each person was detected by the color Doppler ultrasound.Results The percentage of people who had a high level of Hcy was 41.6％ (79/190) ; the average age and male rate in this group were much higher than those in Hcy normal group [(56 ± 10) years vs (52 ± 8) years,t =-0.31,P ＜0.01 ;74.7％ (59/79) vs 33.3％ (37/111),x2 =31.57,P ＜ 0.01].In Hcy normal group,29 cases (26.1％) were mild stenosis,5 cases (4.5％) were moderate stenosis and 4 cases (3.6％) were severe stenosis or occlusion; those in homocysteine group were 31 cases (39.2％),17 cases (21.5％),7 cases (8.9％),respectively.Compared with Hcy normal group(8.1％),the detection rate of moderate and severe stenosis of common carotid artery in high Hcy group was 30.4％ (x2 =27.98,P ＜ 0.01).Conclusion High level of Hcy in middle and ole aged people is related with common carotid atherosclerosis.
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