老年脑梗死患者血同型半胱氨酸水平与颈动脉狭窄的相关性研究

The relationship between serum homocysteine and carotid stenosis in patient with aged cerebral infarction

目的研究65岁以上老年脑梗死患者血同型半胱氨酸（homocysteine,Hey）水平与颈动脉狭窄之间的关系。方法从本院2007年1月~2009年12月在本医院神经内科收治的脑梗死患者中选择动脉粥样硬化性脑梗死198例,均行颈部血管双源CT（dualsource CT,DSCT）扫描,并比较不同组别颈动脉狭窄程度与血同型半胱氨酸水平的关系。结果发现无狭窄61例;有狭窄137例,其中轻度狭窄55例、中度狭窄48例,重度狭窄34例。无狭窄患者血Hcy水平（12.88±3.59）μmol/L明显低于有狭窄患者（23.22±4.68）μmol/L（P〈0.001）。轻度狭窄组血Hcy水平（18.44±6.35）μmol/L明显低于中度狭窄组（22.52±5.58）μmol/L,中度狭窄组明显低于重度狭窄组（27.33±5.36）μmol/L,各组间Hcy水平比较有显著差异（P〈0.05）。Pearson等级相关分析显示,血Hcy水平与颈动脉狭窄呈正相关（r=0.411,P〈0.001）。颈动脉粥样硬化危险因素Logistic回归分析显示高半胱氨酸血症（HHcy）不构成颈动脉狭窄独立危险因素（P=0.238）。结论血Hcy水平与颈动脉狭窄之间无明显关系,且不是颈动脉狭窄的独立危险因子。

Objective To study the relationship between serum homocysteine（Hcy） and carotid stenosis in patients with aged cerebral infarction.Methods 198 patients with aged cerebral infarction were examined dualsource CT（DSCT）.Patients with carotid stenosis were further grouped as without（61）,slight（55）,moderate（48） and severe stenosis（34）.Results The level of Hcy significantly was lower in patients without carotid stenosis（12.88±3.59） μmol/L than that in patients with carotid stenosis （23.22±4.68） μmol/L（P〈0.001）.The level of Hcy was significantly lower in patients with mild stenosis（18.44±6.35） μmol/L than that in patients with moderate stenosis（22.52±5.58） μmol/L（P〈0.05）.The level of Hcy was significantly lower in patients with moderate stenosis than that in patients with severe stenosis（27.33±5.36）μmol/L（P〈0.05）.Spearman rank correlation analysis showed that Hcy level and the degree of carotid stenosis was positively correlated（r=0.411,P〈0.001）.Logistic regression analysis showed that Hcy level is not an independent risk factor of carotid stenosis（P=0.238）.Conclusions There was a correlation between Hcy level and the severity of the carotid stenosis,but not an independent risk factor for carotid stenosis.