同型半胱氨酸及低密度脂蛋白与颅内外动脉狭窄程度相关性分析

Correlation analysis between homocysteine,low density lipoprotein cholesterol and intracranial arterial stenosis

目的探讨缺血性脑卒中患者同型半胱氨酸及低密度脂蛋白水平与颅内外动脉狭窄程度的相关性。方法选择2013年1月~2014年12月在我院神经内科诊治的60例缺血性脑卒中患者作为观察组,同时选择60例健康体检者作为对照组。抽血检测血同型半胱氨酸、低密度脂蛋白等相关指标;并行头、颈部CE-MRA检查颅内外动脉血管情况。结果观察组血同型半胱氨酸水平为(18.19±6.23)μmol/L,高于对照组的(11.23±5.46)μmol/L,差异有统计学意义(P<0.05)。按照颅内动脉狭窄程度分为轻、中、重三个亚组。三组的同型半胱氨酸水平均增加,并高于对照组,差异有统计学意义(P<0.05)。同时三个亚组进行两两比较,重度狭窄组血同型半胱氨酸水平升高最明显,差异有统计学意义(P<0.05);而组间低密度脂蛋白水平比较,差异无统计学意义(P>0.05)。血同型半胱氨酸水平与脑血管狭窄程度成正相关(r=0.68,P<0.05)。多元回归分析显示高血压、高同型半胱氨酸水平与脑血管狭窄密切相关。结论血同型半胱氨酸、低密度脂蛋白水平升高是脑血管狭窄的危险因素,高同型半胱氨酸血症与脑血管狭窄高度相关,应及时预防及干预高同型半胱氨酸血症,避免缺血性脑血管病的发生。

Objective To investigate the relationship between homocysteine plus low density lipoprotein levels and intracranial arterial stenosis in patients with ischemic stroke.Methods A total of 60 cases as observation group were selected from patients with ischemic stroke who were treated in department of neurology in our hospital from January 2013 to December 2014.Meanwhile,60 normal were selected as the control group at the same time.The blood samples were tested for homocysteine and low density lipoprotein.Head and neck CE-MRA weral e used to check the vascular condition of intracranial arteries.Results The blood homocysteine level in the observation group was（18.19±6.23） μmol/L,and wihch was higher than that in the control group（[11.23±5.46] μmol/L）（P〈0.05）.The patients in,intracranial artery stenosis group were subdivided into light,medium and severe groups.The homocysteine level in severe stenosis group was statistically significant than that in other two groups（P〈0.05）.There was no statistical difference in LDL levels between three subgroups（P〉0.05）.Homocysteine was positively correlated with the degree of cerebral vascular stenosis（r =0.68,P〈0.05）.Multiple regression analysis showed that hypertension and homocysteine levels were closely related to cerebrovascular stenosis.Conclusion Blood homocysteine and low density lipoprotein level both are risk factors for cerebral vascular stenosis,and high homocysteine is highly correlated with cerebral vascular stenosis.Prevention and intervention for high level of homocysteine should be timely considered to avoid the occurrence of ischemic cerebrovascular disease.