同型半胱氨酸测定在急性脑梗塞合并颈动脉病变的临床应用价值分析

The clinical value of homocysteine in acute cerebral infarction with carotid artery lesions

目的探讨急性脑梗塞伴颈动脉病变同血同型半胱氨酸水平的相关性。方法将215例初发急性脑梗塞患者根据其空腹同型半胱氨酸(Hcy)值分为低同型半胱氨酸组103例及高同型半胱氨酸组112例。主要比较两组脑梗塞患者斑块和颈动脉狭窄的发生率以及严重程度。结果斑块以及严重的动脉狭窄更容易发生在急性脑梗塞高Hcy组。血浆Hcy的水平与斑块以及软斑的数量具有正相关性(kendall相关系数为0.145,P=0.006<0.05);血浆Hcy的水平与重度动脉狭窄的发生率呈正相关(kendall相关系数为0.359,P=0.000<0.05)。结论急性脑梗塞患者血浆Hcy水平与颈动脉斑块和狭窄发生率呈正相关,提示积极干预高同型半胱氨酸血症有助于预防颈动脉病变。

Objective The purpose of this study was to investigate the correlation between homocysteine levels and carotid artery lesion in acute cerebral infarction. Methods A total of 215 patients with clinically diagnosed acute cerebral infarction were divided into two groups, the high Hcy group（n=103） and the low Hcy group（n=112）. Results Plaques and severe arterial stenosis are more likely to occur in high Hcy group. The level of plasma Hcy positively correlated to the number of plaque and soft plaque（Kendall correlation coefficient=0.145, P=0.0060.05）; the relation between plasma Hcy levels and the incidence of severe arterial stenosis was positive（Kendall correlation coefficient=0.359, P=0.0000.05）.Conclusion Plasma Hcy levels in the patients with acute cerebral infarction were positively correlated with the incidence of carotid plaques and stenosis, suggesting active intervention of hyperhomocysteinemia might be of help for the prevention of carotid artery plaques and stenosis.