同型半胱氨酸和C反应蛋白与青年脑梗死颈动脉粥样硬化的关系

Relationship between serum homocysteic acid or serum C-reactive protein and carotis atherosclerosis of young adult patients with cerebral infarction

目的研究血清同型半胱氨酸(HCY)和C反应蛋白(CRP)与青年脑梗死患者颈动脉粥样硬化形成的关系。方法对2007年1月～2010年9月在江西省人民医院住院的112例年龄小于45岁的脑梗死患者进行血清HCY和CRP水平测定及颈动脉血管彩色B超检查(观察颈动脉有无斑块形成以及斑块的稳定性),并与对照组(同期在该院体检的健康者)进行比较。结果脑梗死组颈动脉斑块发生率及血清HCY和CRP水平高于对照组,两者差异有统计学意义(P<0.01)。112例急性脑梗死中,稳定斑块组和不稳定斑块组血清HCY和CRP水平均高于无斑块组,与无斑块组相比差异有统计学意义(P<0.01);不稳定斑块组血清CRP水平高于稳定斑块组,与稳定斑块组比较差异有统计学意义(P<0.05)。结论早发性动脉粥样硬化是青年脑梗死的重要病因。血清HCY和CRP水平升高,可预测颈动脉粥样硬化形成,是青年脑梗死发病的重要危险因素。临床上对脑梗死患者,尤其是既往无传统脑血管病危险因素的青年患者,应将血清HCY和CRP测定作为与血糖、血脂一样重要的常规检测项目。早期发现和早期干预高水平的HCY和CRP可能是预防脑梗死尤其是青年脑梗死发生的一个重要途径。

[Objective] To observe the relationship between serum homoeysteic （HCY） acid or serum Creactive protein （CRP） and carotid atherosclerosis of young adult patiex^ts of cerebral infarction. [Methods ] In this study, a total of 112 less than 45 years old adult patients with acute cerebral infaretion who were hospitalized in Department of Neurology, the Jiangxi Provincial People＇s Hospital between January 2007 and September 2010. They were detected serum HCY and serum CRP, and earotis by diasonography （observed Plaque and stability of plaque in carotid artery）. Meanwhile they were compared with healthy people who were medical examination in my hospital. [Results] Comparing with control group, plaques in carotid artery of cerebral infarction group were more, and serum HCY and serum CRP of cerebral infarct group were higher （P〈0.01）. Comparing with without plaque group, serum HCY and serum CRP of with plaque group were higher significantly （P〈0.01）. In comparison with stable plaque group, the serum CRP levels of with unstable plaque group were higher. [Conclusion] It is important factor of young patients with cerebral infarct that artherosclerosis were early occurred. The levels of serum HCY and serum CRP were increased prognosticate that carotis atherosclerosis were formed. Then the levels of serum HCY and serum CRP were increased is important risk factor of young patients with cerebral infarct. The high levels of serum HCY and serum CRP were early discovered and early intervented mostly prevent cerebral infarct, especially prevent cerebral infarct those were young patients.