老年急性缺血性脑卒中患者血浆同型半胱氨酸水平与颈动脉粥样硬化的关系研究

Relationship of plasma homocysteine levels and carotid atherosclerosis in elderly patients with acute ischemic stroke

目的探讨老年急性缺血性脑卒中患者血浆同型半胱氨酸水平与颈动脉粥样硬化的关系。方法选取80例老年缺血性脑卒中患者为研究对象,对所有入组对象行颈动脉多普勒彩色超声检查。根据检查结果分为有斑块组和无斑块组。对分组患者的血浆同型半胱氨酸水平(Hcy)及颈动脉内膜中层厚度(IMT)检查结果进行比较,分析患者血浆同型半胱氨酸水平与颈动脉粥样硬化的关系。结果 (1)斑块组患者44例Hcy水平升高,8例Hcy水平正常;无斑块组8例Hcy水平升高,20例Hcy水平正常,2组比较差异有统计学意义(χ2=25.12,P=0.00)。(2)正常组Hcy水平(18.22±3.17)μmol/L<轻度狭窄组(26.13±5.24)μmol/L<中重度狭窄组(33.21±5.79)μmol/L,组间比较差异有统计学意义(F=16.96,P<0.05);正常组IMT为(0.81±0.07)mm<轻度狭窄组(1.13±0.21)mm<中重度狭窄组(1.35±0.33)mm,组间比较差异有统计学意义(F=14.00,P<0.05)。结论高Hcy水平及颈动脉粥样硬化斑块的形成与缺血性脑卒中的发生具有密切的关系。

Objective To investigate the relationship between plasma homocysteine levels and carotid atherosclerosis in elderly patients with acute ischemic stroke. Methods 80 elderly patients with ischemic stroke were chosen for the study. All underwent carotid Doppler color ultrasound examination. According to test results ,they were divided into with and without plaque plaque group.The plasma homocysteine （Hcy） and carotid artery intima-media thicknesses （IMT） of two groups were compared ,the relationship between plasma homocysteine levels and carotid atherosclerosis was analyzed.Results The Hcy lev-els of 44 patients in plaque group elevated ,8 patients with normal Hcy levels ;in without plaque group ,levels of Hcy of 8 pa-tients elevated ,Hcy levels of 20 patients were normal ,the data of two groups were statistically campared ,the difference was statistically significant （χ2 =25.12 , P＜ 0.001）. Normal group Hcy levels （18.22 ±3.17） μmol/L ＜ mild stenosis group （26.13± 5.24）μmol/L ＜ moderate to severe stenosis group （33.21 ±5.79）μmol/L ,there were statistically significant differ-ence between the two groups （F=16.96 ,P＜0.05）;IMT normal group was （0.81± 0.07） mm ＜ mild stenosis group （1.13±0.21） mm ＜ moderate to severe stenosis group （1.35± 0.33） mm ,the difference was statistically significant between the two groups （F=14.00 , P＜ 0.05）.Conclusion High Hcy levels and carotid atherosclerotic plaque formation and the occur-rence of ischemic stroke have a close relationship.