缺血性脑卒中患者血同型半胱氨酸水平与颈动脉斑块及性质的相关分析

The correlation of serum homocysteine level with carotid plaque in ischemic stroke patients

目的研究缺血性脑卒中患者血浆同型半胱氨酸水平与颈动脉斑块及性质的关系。方法选择我院神经内科住院的急性缺血性脑卒中者112例为研究对象,通过颈动脉彩超检查按有无颈动脉斑块分为颈动脉斑块形组和无颈动脉斑块组,所有研究者采用荧光偏振免疫法测定血浆同型半胱氨酸(Hcy)水平。结果 (1)颈动脉斑块组和颈动脉无斑块组同型半胱氨酸[(16.56±7.5)vs(11.25±6.3)]、高密度脂蛋白(HDL-C)[(1.01±0.23)vs(1.25±0.43)]、低密度脂蛋白(LDL-c)[(2.87±0.75)vs(2.5±0.76)]比较差异有统计学意义(P<0.05)。(2)颈动脉斑块组中按斑块性质分为稳定斑块组和不稳定斑块组,两者同型半胱氨酸水平[(13.86±4.24)vs(15.78±6.46)]比较差异有统计学意义(P<0.05)。结论除高密度脂蛋白降低、低密度脂蛋白升高外,同型半胱氨酸水平升高亦是颈动脉斑块形成的危险因素,同时高同型半胱氨酸血症亦是不稳定性斑块形成的重要原因。

Objective To study the correlation o{ serum homocysteine （Hcy） level with carotid plaque in ischemic stroke patients. Methods All 112 patients with acute ischemic stroke in our hospital were divided into carotid plaque group and noncarotid plaque group based on the results of carotid uhrasonography. And Hcy level was tested by fluorescence polarization method. Results There were significant differences in comparison of plaque group with non-plaque group in terms of Hcy level （16.56±7.5 versus 11.25±6.3） ,high-density lipoprotein level （1.01±0.23 versus 1.25±0.43）and low-density lipoprotein level （2.87±0.75 versus 2.5±0.76） （all P〈0.05）. According to plaque property,cases in carotid plaque group were classified into stable-plaque group and unstable-plaque group, which showed statistical difference as for Hcy level （13.86±4.24 ver sus 15.78±6.46）（P〈0.05）. Conclusion In addition to the low level of high-density lipoprotein and the high level of low- density lipoprotein,high Hcy level may be one of risk factors for carotid plaque and may be regarded as an important cause for unstable plaque.