血浆同型半胱氨酸水平与腔隙性脑梗死患者颈动脉搏动指数相关性的探讨

Preliminary study of the relationship between plasma total homocysteine level and the pulsatility index of cerebral arteries in lacunar infarction

目的初步探讨血浆总同型半胱氨酸(t Hcy)水平与腔隙性脑梗死患者颈动脉搏动指数(PI)的关系。方法选取腔隙性脑梗死患者90例和对照组30例,利用化学发光微粒子免疫检测法检测患者血浆t Hcy水平;借助脑血管功能检测仪测定两侧颈动脉血流运动学参数,包括颈动脉最大血流速度(Vmax)、最小血流速度(Vmin)、平均血流速度(Vmean);利用公式求得PI,PI=(Vmax-Vmin)/Vmean。结果腔隙性脑梗死组患者血浆t Hcy自然对数值(lnt Hcy)与颈动脉搏动指数自然对数值(ln PI)呈正相关(r=0.326,P=0.002),与Vmax、Vmin、Vmean、Qmean均呈负相关(相应r=-0.283,P=0.007;r=-0.417,P=0.000;r=-0.389,P=0.000;r=-0.261,P=0.013),而对照组无此相关性。回归分析显示,血浆t Hcy水平是PI大小的影响因素。结论血浆t Hcy水平和颈动脉PI之间有显著的相关性,血浆t Hcy可能诱导脑部小动脉血管的循环障碍,从而促进腔隙性脑梗死的发生。

Objective To investigate the relationship between plasma total homocysteine（t Hcy） levels and the pulsatity index of cerebral arteries in lacunar infarction. Methods A total of 90 cases of Lacunar infarction patients and the 30 cases of control group were enrolled for the study. The plasma t Hcy level was detected by chemiluminescent micro particle immunoassay. With Cerebral blood vessel analyzer, the kinematic parameters of bilateral carotid artery were measured, which including maximum carotid blood flow velocity（Vmax）, the minimum flow velocity（Vmin）, mean flow velocity（Vmean）. PI was calculated as PI=（Vmax-Vmin） / Vmean）. Results Plasma t Hcy in patients with Lacunar infarction group is positively correlated with the natural logarithm of the carotid artery pulsatility index（PI）,（r=0.326, P=0.002）, and negatively correlated with Vmax, Vmin, Vmean, Qmean（Respectively r=-0.283,P=0.007; r=-0.417, P=0.000;r =-0.389,P =0.000; r =-0.261,P =0.013）,while in the control group was no such correlation. The regression analysis of PI found that plasma t Hcy is a risk factor for the PI. Conclusion There is a significant correlation between plasma t Hcy levels and cerebral artery pulsatility index, plasma t Hcy-induced circulatory disorder of small blood vessels,leading to the development of microvascular disease.