高同型半胱氨酸血症与青年急性脑梗死的相关性研究

摘要

目的探讨血浆同型半胱氨酸（Hcy）与青年急性脑梗死及颈动脉粥样硬化的关系。方法从2011年2月至2013年2月本院收治的1800例脑梗死患者中筛选123例45岁以下脑梗死患者为病例组，选取本院体检中心健康体检者30例为对照组，比较两组患者同型半胱氨酸水平。将患者按同型半胱氨酸水平分为两组，比较两组之间血脂、血压、血糖水平及颈动脉粥样硬化发生情况。结果脑梗死患者的血浆同型半胱氨酸水平高于正常对照组；病例组和对照组血浆同型半胱氨酸水平分别为（21.43±19.96）μmol/L、（15.12±9.53）μmol/L，差异具有显著性（P＜0.05）；两组患者中，男性的血浆同型半胱氨酸水平高于女性；比较高Hcy组和正常Hcy组的血糖、血脂及血压差异无显著性（P＞0.05）；脑梗死患者中高Hcy组的颈动脉血管内皮增厚或斑块形成比例明显高于无Hcy升高的患者，两者比较差异具有显著性（P＜0.05）。结论高同型半胱氨酸血症是导致动脉硬化及青年脑梗死的独立危险因子，尤其对男性青年脑梗死患者要注意血浆同型半胱氨酸的检测；高同型半胱氨酸血症早期发现及治疗对预防、治疗青年脑梗死有重要意义。%Objective To assess whether elevated plasma homocysteine levels contribute to carotid atherosclerosis and the ischemic stroke in young adults. Methods 123 consecutive patients with ischemic stroke in young adults out of the 1800 inpatients fromFebruary 2011 to February 2013 were recruited, we chose 30 healthy individual as control. we evaluated the plasma homocysteine and carotid atherosclerosis in both group. Results Plasma homocysteine of the patients with infarction is higher than the control (21.43±19.96) μmol/L vs (15.12±9.53) μmol/L (P=0.005).We found more atherosclerosis plaque in patients with hyperhomocysteinemia than those who with normal plasma homocysteine (P =0.035). Conclusion Hyperhomocysteinemia relates to the atherosclerosis, and is an independent risk factor of ischemic Stroke in young adults.