高龄脑梗死患者同型半胱氨酸与颈动脉粥样硬化的特征分析

Homocysteine and features of carotid artery atherosclerosis in very old patients with cerebral infarction

目的 研究高龄脑梗死患者同型半胱氨酸（Hcy）与颈动脉粥样硬化的关系.方法 选择85例高龄脑梗死患者（年龄≥80岁）为高龄组,同时随机选取年龄＜80岁的急性脑梗死患者110例作为对照组.患者均行双侧颈部血管超声检查,并检测血脂、血Hcy、叶酸及VitB12水平,进行相关分析.结果 高龄组颈动脉粥样硬化的发生率为94.12%,显著高于对照组的69.09%（χ^2=22.971,P=0.000）.高龄组动脉粥样硬化程度较对照组严重（P=0.000）.高龄组血Hcy为（21.08±15.22）μmol/L,显著高于对照组（15.99±9.19）μmol/L,差异有统计学意义（P=0.004）.颈动脉粥样硬化程度与血Hcy呈正相关（r=0.572,P=0.000）.结论 高龄脑梗死患者颈动脉粥样硬化的发生率增高,与高Hcy血症密切相关.

Objective To investigate the relationship between the level of homocysteine（Hcy） and the incidence of carotid artery atherosclerosis in very old patients with cerebral infarction and analyze the influencing factors for carotid artery atherosclerosis. Methods Eighty-five very old patients（≥80 years） with cerebral infarction were compared with 110 patients（age〈80 years） as the control group. Clinical feature and the influencing factors for carotid artery atherosclerosis were analyzed. Carotid artery examination by the colour Doppler uhrasonography technique was performed for all patients. The serum levels of Hcy,folate,vitamin B12 ,as well as lipid were detected. Results The incidence of carotid artery atherosclerosis was 94.12% in patients aged ≥80 years and 69.09% in the control group. There was significant difference between the two groups （χ^2 = 22. 971, P = 0. 000）. Hcy level was significantly higher in very old patients than in control group （P = 0. 004）. The levels of Hcy were increased with the increase in carotid artery atherosclerosis severity. Conclusions The incidence of carotid artery atherosclerosis is high in very old patients with cerebral infarction,and is associated with hyperhomocysteinemia.