血浆同型半胱氨酸水平与缺血性脑血管病患者颈动脉粥样硬化斑块的相关性研究

摘要

目的：研究血浆同型半胱氨酸水平和缺血性脑血管病患者颈动脉粥样硬化斑块的相关性。方法：选择2014年10月～2015年11月在我院进行诊治的缺血性脑血管病患者500例，进行颈动脉彩色多普勒超声检查后，根据超声结果分为无斑块组（106例）、不稳定斑块组（261例）与稳定斑块组（133例），检测血浆同型半胱氨酸水平，并分析其与颈动脉粥样硬化斑块的相关性。结果：500例患者中发现无斑块106例（21.2％），颈动脉斑块394例（78.8％）；稳定斑块组和不稳定斑块组的血浆同型半胱氨酸水平较无斑块组明显升高；不稳定斑块组与稳定斑块组相比，同型半胱氨酸水平均明显升高；易损斑块组血浆同型半胱氨酸浓度和高同型半胱氨酸血症发生率均明显高于非易损斑块组；Logistic 回归分析结果显示同型半胱氨酸的水平与颈动脉硬化斑块呈正性相关关系，OR 为1.23，95％ CI 为1.021.22，差异有统计学意义。结论：颈动脉斑块的形成及其稳定性与同型半胱氨酸水平关系紧密，同型半胱氨酸水平升高是颈动脉斑块形成的独立危险因子。%Objective To investigate the relationship of plasma homocysteine and carotid atherosclerotic plaque in patients with ischemic cerebrovascular disease. Methods Selected 5000 cases of patients with ischemic cerebrovascular disease who were treated in our hospital from September 2014 to November 2015. According to the results of carotid color Doppler ultra-sound examination, divided into no plaque group (106 cases), unstable plaque group (261 cases) and stable plaque group (133 cases). Detected the levels of plasma homocysteine and analyzed their correlation with carotid atherosclerosis plaque. Results Of the 500 patients, 106 patients (21.2%) had no plaque, and 394 patients (78.8%) had carotid plaques no plaque was found in 106 cases(21.2%), 394 cases (78.8%) of carotid plaques were found; the plasma homocysteine level in the stable plaque group and the unstable plaque group was significantly higher than that in the non plaque group, the incidence of high homocysteine was significantly higher, and the level of homocysteine was significantly higher, and the incidence of homocysteine was signifi-cantly higher; the concentrations of plasma homocysteine and homocysteine in vulnerable plaque group were significantly higher than those in non vulnerable plaque group; Logistic regression analysis showed that the level of homocysteine was positively correlated with carotid atherosclerosis plaque, OR was 1.23, 95% CI was 1.02 1.22, and the difference was significant. Conclu-sion The formation and stability of carotid plaque are closely related with homocysteine, and the elevated level of homocysteine is an independent risk factor for carotid plaque formation.