老年无症状性脑梗死患者血清同型半胱氨酸水平和颈动脉粥样硬化的关系

Relationship between serum homocysteine level and carotid atherosclerosis in the elderly patients with asymptomatic cerebral infarction

目的:探讨老年无症状性脑梗死(ACI)患者血清同型半胱氨酸(Hcy)水平与颈动脉粥样硬化的关系。方法:采用酶联免疫吸附法(ELISA)测定183例ACI患者和185例健康人血清Hcy水平;对183例ACI患者进行颈动脉彩色多普勒超声检测,并根据Hcy水平将ACI分为Hcy正常组(Hcy≤20μmol/L)和Hcy升高组(Hcy>20μmol/L)。结果:ACI组血清Hcy水平(25.3±8.6)μmol/L高于对照组((15.3±5.6)μmol/L,(P<0.01)。Hcy升高的ACI患者其颈动脉粥样硬化及中重度粥样硬化的发生率分别为68.8%和46.9%,高于Hcy正常的ACI患者(分别为30.9%和16.4%,P均<0.01)。Hcy升高的ACI患者其颈动脉狭窄和中重度狭窄的发生率分别为70.3%和46.9%,高于Hcy正常组(27.3%和9.1%,P均<0.01)。结论:老年ACI患者血清Hcy水平与颈动脉粥样硬化有关。

Aim： To investigate the relationship between serum homocysteine （Hey） level and carotid atherosclerosis in the elderly patients with asymptomatic cerebral infarction （ACI）. Methods：The serum Hcy levels were measured by ELISA in 183 elderly patients with ACI and 185 healthy controls. Color uhrasonography was used to observe the carotid ath- erosclerosis and the severity of stenosis of the extracranial carotid in 183 elderly patients with ACI. The 183 ACI patients were allocated into normal Hcy level group （ Hcy≤20μ mol/L） and high Hcy level group （ Hcy 〉 20 μmol/L） group. Re- sults： The serum Hcy level in ACI group（ （25.3± 8.6） μ mol/L） was significantly higher than that in the control group （ （ 15.3±5.6） μ mol/L,P 〈 0.01 ）. The rate of carotid atherosclerosis （ 68.8% ） and the moderate to severe carotid atherosclerotic rate （46.9%） in high Hcy level group were significantly higher than those （30.9% and 16.4% ,respectively） in normal Hcy level group （all P 〈 0.01 ）. The rates of carotid stenosis （70.3%） and the moderate to severe carotid stenosis （46.9%） in high Hcy level group were also significantly higher than those （27.3% and 9. 1% , respectively） in normal Hcy level group （P 〈 0.01 ）. Conclusion： The serum Hcy level in the elderly patients with ACI is associated with carotid atherosclerosis.