脑梗死患者血清同型半胱氨酸水平与颈动脉粥样硬化的相关性研究

摘要

Objective To study the relationship between homocysteine (Hcy)and carotid atherosclerosis in patients with cer-ebral infarction.Methods During January and November 2013,281 patients with cerebral infarction from Affiliated Hospital of Yan’an University were provided the blood samples as cerebral infarction group,140 healthy volunteers served as control group.Serum Hcy was detected by enzymatic cycle assay.According to the results of carotid artery ultrasonography,cerebral infarction group was divided into five groups:artery normal group,intimal thickening group,soft plaque group,mixed plaque group and hard plaque group.The statistically significance was analyzed by SPSS 19.0.Results The serum Hcy level of cer-ebral infarction group was 19.78 ± 5.21 μmol/L,significantly higher than the control group 10.24 ± 3.33 μmol/L (P <0.001).The serum Hcy levels of control group,artery normal group,intimal thickening group,soft plaque group,mixed plaque group and hard plaque group were 10.24±3.33,15.20±2.99,17.03±1.85,25.44±4.24,19.65±4.74 and 18.31 ±3.67 μmol/L respectively.The differences between groups were statistically significant in addition to intimal thickening group and hard plaque group (P =1.106).The positive rates were 16.4%,53.7%,87.1%,95.7%,83.1% and 77.3% re-spectively,the groups which in cerebral infarction group compared with control group,the differences were statistically sig-nificant (P <0.001).Conclusion Hcy played an important role in the occurrence and development of cerebral infarction. Lower serum Hcy concentration,may be an effective way to prevent carotid atherosclerosis and cerebral infarction.%目的：研究脑梗死患者血清同型半胱氨酸（Hcy）水平与颈动脉粥样硬化的相关性。方法选择2013年1月～11月入住延安大学附属医院的脑梗死患者281例为脑梗死组，以同期140例体检正常者作为对照组，采用循环酶法测定血清Hcy 水平，并进行颈动脉彩色多普勒超声检查，根据颈动脉超声检查结果将脑梗死组进一步分为动脉正常组、内膜增厚组、软斑组、混合斑组及硬斑组，采用统计学软件包 SPSS 19.0进行分析。结果脑梗死组患者血清 Hcy 水平为19.78±5.21μmol／L，明显高于对照组10.24±3.33μmol／L（P ＜0.001）。对照组、颈动脉正常组、内膜增厚组、软斑组、混合斑组及硬斑组 Hcy 水平分别为10.24±3.33，15.20±2.99，17.03±1.85，25.44±4.24，19.65±4.74及18.31±3.67μmol／L，除内膜增厚组与硬斑组比较差异无统计学意义（P ＝0.106），其余各组之间比较差异均有统计学意义（P ＜0.05）；阳性率分别为16.4％，53.7％，87.1％，95.7％，83.1％和77.3％，脑梗死各组与对照组相比差异均有统计学意义（P ＜0.001）。结论Hcy 在颈动脉粥样硬化的发生、发展中起重要作用，可用于脑梗死早期诊断，降低血清 Hcy 浓度，可能是预防颈动脉粥样硬化及脑梗死的有效途径。