急性脑梗死患者血清同型半胱氨酸水平与下肢动脉粥样硬化程度的关系

The relationship between blood HCY levels and lower extremity artheriosclerosis in patients with acute cerebral infarction

目的探讨急性脑梗死患者血清同型半胱氨酸(homocysteine,HCY)水平与下肢动脉粥样硬化程度的关系。方法选取住院确诊的急性脑梗死患者110例,均行下肢动脉彩超检查,根据下肢动脉超声检查的结果分为无斑块组(27例)、稳定斑块组(45例)和不稳定斑块组(38例),比较3组之间HCY水平。同时根据HCY测定结果分为HCY低水平组(5～15μmol/L)、HCY中水平组(15～26μmol/L)和HCY高水平组(≥26μmol/L),比较3组间双侧下肢动脉IMT厚度。结果不稳定斑块组的HCY水平(36.85±16.86)μmol/L高于稳定斑块组(23.74±15.42)μmol/L和无斑块组(9.23±6.78)μmol/L,差异有统计学意义(P均<0.001)。高HCY水平组IMT厚度(左1.37±0.74,右1.41±0.73 mm)高于低HCY水平组IMT厚度(左0.91±0.58,右0.92±0.46 mm),差异有统计学意义(左P=0.001,右P=0.004)。结论血清HCY水平随着下肢动脉粥样硬化斑块的加重逐渐升高,高HCY水平与动脉粥样硬化斑块的不稳定有关。对急性脑梗死高HCY血症者应积极干预治疗,以防病情进一步恶化。

Objective To investigate the relationship between blood HCY level and lower extremity arthe- riosclerosis in patients with acute cerebral infarction. Methods The study included a total of 110 patients with acute cerebral infarction. Color Doppler uhrasonography and ELISA were used to detect lower extremity arteriosclerosis and the serum HCY levels, respectively. The patients were divided into three groups according to the severity of arte-riosclerosis as judged by Color Doppler uhrasonography： no plaque group （27 cases）, stable plaque group （45 cas-es） and unstable plaque group （38 cases）. The patients were further divided into three groups based on their HCY levels： low HCY level group （5 - 15 μmol/L）, middle HCY level group （15 - 26 μmol/L） and high HCY level group （I〉26 μmol/L）. Results The blood HCY levels were higher in unstable plaque group （36.85 ±16.86 μmol/L） than in either the stable plaque group （23.74 ± 15.42 p.mol/L） or no plaque group （9.23 ± 6.78 p.mol/L）. There was a statistically significant in HCY levels between the stable plaque group and no plaque group （P 〈 0.1301 ）. IMT thickness was much thicker in high HCY level group （left 1.37 ±0.74, right 1.41± 0.73 mm） than in low HCY level group （left 0.91 ± 0.58, right 0.92 ± 0.46 ram） （left P = 0.001, right P = 0.004）. Conclusions HCY levels may gradually increase as the lower extremity atherosclerosis plaques progress. High HCY levels are associated with a relationship with atherosclerosis unstable plaques.