脑梗死与血管活性物质及同型半胱氨酸的相互关系

The correlation between cerebral infarction and vasoactivators and homocysteinemia

目的 探讨脑梗死患者颈动脉病变 ,血管活性物质 [一氧化氮 (NO)、内皮素 (ET 1) ]及同型半胱氨酸 (Hcy)的相互关系。方法 选择 14 9例高血压患者 ,按有无缺血性脑卒中分为 2组 ,A组 :高血压并发缺血性脑卒中组 (74例 )。B组 :单纯高血压病组 (75例 ) ,对上述患者测定血清中NO、ET 1、Hcy值 ,颈动脉超声。结果 缺血性脑卒中组Hcy、ET 1生成增加 ,NO生成减少 ,差异有显著性 (P <0 .0 5 )。颈动脉斑块的发生A组较B组明显增多 ,差异有显著性 (P <0 .0 5 )。结论 高Hcy加重了高血压对血管壁的损伤 ,使血管内皮细胞中NO生成减少 ,ET 1生成增加 ,斑块的形成增加 ,从而促进了血管内血栓的形成 。

Objective To assess the relationship between carotid lesions and some vasoactivators as well as homocysteinemia in patients with hypertension.Methods 149 Hypertensive patients were divided into two groups:group A,74 patients with both hypertension and cerebral infarction;group B,75 hypertensive patients without infarction.The homocysteine(Hcy),nitrogen monoxide(NO) and endothelin(ET 1) levels of all these patients were assessed.The ultrasonography of carotid artery was also performed at the same time.Results In group A,Hcy and ET 1 levels were higher and NO level was lower than those in group B with significant difference (P< 0.05 ).The incidence of carotid artery plaque in group A was much higher than that in group B(P<0.05).Conclusion The impairment of the arterial wall induced by hypertension was aggravated by hyperhomocysteinemia,thus enhancing the development of arterial thrombosis and the risk of cerebral infarction.