同型半胱氨酸与颈动脉粥样硬化、脑梗死的关系

The relationship between homocysteine and carotid atherosclerosis as well as cerebral infarction

目的研究同型半胱氨酸(Hcy)与颈动脉粥样硬化(AS)的关系,探讨其对缺血性脑卒中事件预测的临床意义。方法对85例脑梗死患者(病例组)与30倒健康体检者(对照组)采用高效色谱分析法进行Hcy水平测定,并进行彩色多普勒超声进行颈动脉检测。结果病例组和对照组空腹血浆Hcy升高分别有29例和4例,占34．2％和13．3％,血浆Hcy浓度分别为 (19．28±4．33)μmol/L和(11．32±3．86)μmol/L,差异有统计学意义(P<0．001);对照组有颈AS 3例,平均血浆Hcy浓度 (18．55±3．66)μmol/L;无颈AS 27例,平均血浆Hcy浓度(10．13±3．50)μmol/L,差异有统计学意义(P<0．05);44例正常Hcy 脑梗死患者发生颈AS28例,轻度15例,中度8例,重度5例,颈动脉狭窄程度轻度18例,中度5例,重度5例;41例高Hcy脑梗死患者发生颈AS 25例,轻度6例,中度12例,重度7例,颈动脉狭窄程度轻度4例,中度10例,重度11例。结论高同型半胱氨酸血症是动脉硬化期的一个独立危险因素,也是缺血性脑卒中的一个独立危险因素。

Objective To study the relevance between homocysteine and carotid atherosclerosis as well as to discuss its clinical meaning on the prediction for brain stroke event. Methods To assay the Hey levels in 85 cases of cerebral infarction patients （patients group） and 30 cases of health check （control group） by HPLC.At the same time, doppler ultrasongraphy was applied to assay the carotid artery. Results There were 29 cases and 4 cases whose Hey levels have increased respectively, which account for 34.2% and 13.3% with plasma concentration being （19.28 ± 4. 33） μmol/L and （ 11. 32 ±3.86） μmol/L respectively. The difference was significant statistically （ P 〈 0.001 ） . There are 3 cases of AS in the control group with the averaged plasma Hey concentration being （18.55 ± 3.66） μmol/L.There were 27 cases without AS with the averaged plasma Hey concentration being （10.13 ± 3.50） μmol/L.The difference was significant statistically （ P 〈 0.05） .There were 28 cases of AS in 44 cases of normal cerebral infarction with 15 cases of the mild, 8 cases of the moderate and 5 cases of the severe.According to the degree of the straitness of carotid artery, there were 18 cases of the mild, 5 cases of the moderate and 5 cases of the severe. There were 25 cases of AS in 41 cases of high Hey cerebral infarction patients with 6 cases of the mild, 12 cases of the moderate and 7 cases of the severe. Concerning the straitness of carotid artery, there were 4 cases of the mild, 10 cases of the moderate and 11 cases of the severe. Conclusion High levels of homocysteine in plasma should be an independent risk factor in atherosclerosis and also the independent risk factor for cerebral infarction.