AT亚型脑梗死患者脑动脉狭窄与血清同型半胱氨酸浓度的关系

Relationship between cerebral arterial stenosis and homocysteine level in patients with atherothrombosis subtype of cerebral infarction

目的研究动脉粥样硬化性型(atherothrombosis,AT)急性脑梗死患者血同型半胱氨酸(homocysteine,Hcy)水平与颈动脉斑块及脑动脉狭窄之间的关系。方法从2009年1月～2011年5月在我院神经内科住院的脑梗死患者中选出符合改良TOAST分型中AT型的急性脑梗死患者120例,颈动脉彩色多普勒超声检测颈动脉颅外段血管狭窄程度和斑块情况,应用3.0 MRI仪器检测颅内段血管狭窄情况,同时测定血清Hcy水平,将其分为高同型半胱氨酸组(A组)和正常同型半胱氨酸组(B组)。结果 A组患者颈动脉斑块检出率及不稳定斑块发生率均明显高B组,差异有统计学意义(P<0.05);Hcy水平与颈动脉斑块数量呈显著正相关性(P<0.05)。A组颅外段及颅内段血管狭窄率均高于B组,其中轻、中度血管狭窄率A组低于B组,但重度狭窄率A组显著高于B组,差异有统计学意义(P<0.05)。结论血Hcy水平与AT亚型急性脑梗死相关,并且随着Hcy值增高颈动脉斑块形成增多,脑动脉狭窄发生率增高且狭窄程度也随之增高。

Objective To investigate the relationship between homocysteine（Hcy） level and carotid plaques or cerebral arterial stenosis in patients with atherothrombosis type（AT） of acute cerebral infarction.Methods 120 patients with AT subtype of acute cerebral infarction according with modified TOAST types were selected from cerebral infarction patients in our hospital from January 2009 to May 2011.Extracranial carotid artery stenosis degree and plaques situation were detected by carotid artery color Doppler ultrasound.Cerebrovascular stenosis was detected by 3.0 MRI instrument.At the same time Hcy level was also detected,then patients were divided into high homocysteine group（group A） and normal homocysteine group（group B）.Results The detection rate of carotid plaques and unstable plaques in group A were significantly higher than those in group B（P 0.05）;there was a significant positive correlation between Hcy level and carotid plaques quantities（P 0.05）.The extracranial and intracranial blood vessel stricture rates of group A were all higher than those of group B,among which mild-moderate blood vessel stricture rates of group A were less than those of group B,the severe stricture rate of group A was significantly higher than group B（P 0.05）.Conclusion Hcy level is associated with AT subtype of acute cerebral infarction.The numbers of carotid plaques,incidence and narrow-degree of cerebral artery stenosis are all along with the increasing of Hcy level.