血清同型半胱氨酸水平与急性缺血性脑卒中患者颈动脉粥样硬化斑块稳定性及神经功能缺损程度的相关性研究

Relationship Between Serum Hcy Levels and Carotid Artery Atherosclerosis Plaque Stability and the Degree of Neurological Deficits in Patients with Acute Ischemic Stroke

目的探讨血清同型半胱氨酸(Hcy)水平与急性缺血性脑卒中患者颈动脉粥样硬化斑块稳定性及神经功能缺损程度的相关性。方法选取来宾市人民医院2012年12月—2015年12月收治的急性缺血性卒中患者60例作为观察组,根据颈动脉粥样硬化斑块稳定性分为无斑块组15例、稳定性斑块组20例、不稳定性斑块组25例,根据颈动脉狭窄程度分为正常组11例、轻度狭窄组23例和中重度狭窄组26例,根据美国国立卫生研究院卒中量表(NIHSS)评分分为低分组12例、中分组21例、高分组27例;另选取同期体检健康者60例作为对照组。比较两组受试者血清Hcy水平,比较不同颈动脉粥样硬化斑块稳定性、颈动脉狭窄程度及神经功能缺损程度的急性缺血性脑卒中患者血清Hcy水平。结果观察组患者血清Hcy水平高于对照组(P<0.05)。轻度狭窄组和中重度狭窄组患者血清Hcy水平高于正常组,中重度狭窄组患者血清Hcy水平高于轻度狭窄组(P<0.05)。稳定斑块组和不稳定斑块组患者血清Hcy水平高于无斑块组,稳定斑块组患者血清Hcy水平高于不稳定斑块组(P<0.05)。中分组和高分组患者血清Hcy水平高于低分组,高分组患者血清Hcy水平高于中分组(P<0.05)。结论血清Hcy水平与急性缺血性卒中患者颈动脉粥样硬化斑块稳定性和神经功能缺损程度有关。

Objective To discuss the relationship between serum Hcy level and carotid artery atherosclerosis plaque stability and the degree of neurological deficits in patients with acute ischemic stroke. Methods 60 cases acute ischemic stroke patients were selected as observation group in Laibin People’ s Hospital from December 2012 to December 2015,they were A1group（ n = 20）,A2 group（ n = 25） and A3 group（ n = 15） according to the stability of carotid atherosclerotic plaque,they were B1 group（ n = 11）,B2 group（ n = 23） and B3 group（ n = 26） according to degree of carotid artery stenosis,they were C1 group（ n = 12）,C2 group（ n = 21） and C3 group（ n = 27） according to NIHSS score. Another 60 healthy persons were selected as control group. The levels of serum Hcy were compared between the two groups, and the levels of serum Hcy were compared in acute ischemic stroke patients with difference carotid atherosclerotic plaque, carotid stenosis and the degree of neurological deficit. Results The serum Hcy level of observation group was statistically significantly higher than that of the control group（ P 〈 0. 05）. The serum Hcy level of A2 and A3 groups was statistically significantly higher than that of A1 group,the serum Hcy level of A2 groups was statistically significantly higher than that of A3 group（ P 〈 0. 05）. The serum Hcy level of B2 and B3 groups was statistically significantly higher than that of B1 group,the serum Hcy level of B3 groups was statistically significantly higher than that of B2 group（ P 〈 0. 05）. The serum Hcy level of C2 and C3 groups was statistically significantly higher than that of C1 group,the serum Hcy level of C3 groups was statistically significantly higher than that of C2 group（ P 〈0. 05）. Conclusion The serum Hcy level was correlated with the stability of carotid atherosclerotic plaque and the degree of neurologic impairment in patients with acute ischemic stroke.