缺血性脑血管病患者血清同型半胱氨酸和脂蛋白（a）含量的变化

Changes of serum homocysteine and lipoprotein （a） levels in patients with ischemic cerebrovascular disease

目的：探讨缺血性脑血管病（ICVD）患者血清同型半胱氨酸（Hcy）和脂蛋白（a）[Lp（a）]水平的变化。方法：收集辰溪县人民医院神经内科2009年6月至2010年1月住院治疗的IVCD患者92例，包括脑血栓形成（CT）31例、短暂性脑缺血发作（TIA）29例、脑动脉硬化（CA）32例，以30例健康体检者作为对照组，测定各组血清Hcy和Lp（a）水平并进行比较。比较有无梗死灶的TIA患者血清Hey和Lp（a）水平，分析ICVD患者血清Hcy和[Lp（a）]水平的相关关系。结果：与对照组比较，各组IVCD患者血清Hey[cT组：（22．8±10．5）μmol／L；TIA组：（21．1±9．3）μmol／L；CA组：（18．3±8．6）μmol／L；对照组：（12．2±5．1）la,mol／L]与Lp（a）[cT组：（331．5±127．6）mg／L；TIA组：（258．3±97．7）mg／L；cA组：（226．5±80．3）mg／L；对照组：（137．0±61．9）mg／L]水平均显著增高（P〈0．05）。TIA患者伴有梗死灶者血清Hey和Lp（a）的水平均高于无梗死灶者（P〈0．05）。ICVD患者血清Hcy和Lp（a）水平无相关（P〉0．05）。结论：ICVD患者血清Hcy、Lp（a）水平显著升高，测定ICVD患者血清Hcy和Lp（a）水平可以指导患者的早期干预治疗。

Objective： To explore the changes of serum homocysteine （Hcy） and lipoprotein （a） [ Lp （a） ] levels in patients with ischemic cerebrovascular disease （ICVD）. Methods： Ninety-two patients with ICVD registered to the department of neurology, Chenxi County People′ Hospital, from June 2009 to January 2010 were recruited, including 31 patients with cerebral thrombosis （CT）, 29 patients with transient ischemic attack （TIA） and 32 patients with cerebral arteriosclerosis （CA）, while the control group included 30 healthy individuals registered for routine check-up. The levels of serum Hcy and Lp （a） were examined and compared among the groups, as were examine and compared across TIA patients with or without infarction. The correlation between levels of serum Hcy and Lp（a） in patients with ICVD was analyzed. Results： Compared with the control group, the levels of serum Hey [ CT group ： （22.8±10.5 ）μmol/L, TIA group ： （21.1±9.3 ） μmol/L, CA group ： （18.3±8.6） μmol/L, control group： （12.2±5.1） txmol/L]and Lp（a） [CT group： （331.5±127.6） mg/ L, TIA group： （258.3 -＋97.7） my/L, CA group： （226.5±80.3） my/L, control group： （137.0±61.9） mg/ L] in patients with ICVD increased significantly （all P 〈 0.05 ）. The levels of serum Hcy and Lp （a） in TIA patients with infarction were higher than those without infarction （ all P 〈 0.05 ）. No correlations were found between the levels of serum Hcy and Lp （a） in patients with ICVD （P 〉 0.05 ）. Conclusion： The levels of serum Hcy and Lp（a） may increase significantly in patients with ICVD. Detection of serum Hcy and Lp（a） levels in patients with ICVD may be helpful for early intervention.