脑卒中高危人群血清同型半胱氨酸水平与颈动脉粥样斑块性质相关性研究

Study on the correlation between the homocysteine level and carotid atherosclerosison plaque in population with high risk of stroke

目的探讨血清同型半胱氨酸(homocysteine,Hcy)水平与颈动脉粥样斑块性质之间的相关性。方法 2014年4月-2015年4月在浙江省人民医院总共筛查出脑卒中高危患者547例,通过循环酶法测定血清Hcy水平,彩色多普勒超声诊断仪检查颈动脉粥样斑块性质,分析各组患者的Hcy水平的差异及各组间Hcy水平与颈动脉粥样斑块性质的相关性。结果无斑块组、单发斑块组、多发斑块组Hcy水平差异有统计学意义(P=0.00);不稳定斑块组的血清Hcy水平最高(除混合斑块组外),稳定斑块组次之,无斑块组最低,不同组Hcy水平差异具有统计学意义(P=0.00);绘制ROC曲线,多发斑块组中曲线下面积(0.782)大于单发斑块组(0.712),P=0.000;不稳定斑块组中曲线下面积(0.790)大于稳定斑块组(0.712),P=0.000。结论脑卒中高危患者颈动脉粥样斑块性质与血清同型半胱氨酸水平密切相关,且血清中同型半胱氨酸水平越高,越易形成颈动脉多发斑块及不稳定斑块。

Objective To investigate the correlation between the homocysteine（ Hcy） level and carotid atherosclerosison plaque in population with high risk of stroke. Methods 547 patients with high risk of stroke in Zhejiang People＇s Hospital were screened from April 2014 to April 2015. The serum Hcy level was measured by cycling enzymatic method. Color doppler ultrasonic（ CDU） examination was used to detect the carotid artery plaque. The correlation among the difference of Hcy level in different groups with the levels of Hcy and characteristic of carotid atherosclerosison plaque. Results There was statistical significance on the difference of Hcy levels among multiple plaque group,non- carotid and single plaque group（ P = 0. 00）; and the Hcy level was the highest in the unstable plaque group（ except the mixed- plaque group）,secondary in the stable plaque group,and the lowest in the non- carotid plaque group,with the differences of Hcy levels in different groups statistically significant（ P = 0. 00）. According to ROC curve,the area under curve（ AUC） of multiple plaque group（ 0. 782） was higher than that of the single plaque group（ 0. 712）（ P = 0. 000）; that in the stable plaque group（ 0. 790） was higher than that of the unstable plaque group（ 0. 712）（ P = 0. 000）. Conclusion There is close correlation between carotid plaque and homocysteine levels in patients with high risk of stroke,and the higher the level of homocysteine is,the easier to form multiple carotid arterial plaque and cause unstable plaque.