血清同型半胱氨酸水平与血管造影诊断脑梗死血管狭窄程度的关系分析

Relationship between serum homocysteine and vascular stenosis degree of cerebral infarction diagnosed by CTA

目的 分析血清同型半胱氨酸(Hcy)水平与血管造影(CTA)诊断脑梗死血管狭窄程度间的关系。方法 选取本院2016年2月至2017年2月间收治的378例脑梗死患者作为研究对象,行CTA与血清Hcy检查,统计CTA检查结果,分析Hcy在CTA诊断脑梗死血管狭窄中程度的关系。结果 378例脑梗死患者经CTA检查有341例存在不同程度的血管狭窄或闭塞,37例显示正常,检出率为90.21%;血管狭窄程度:轻、中、重、闭塞分别为85例、91例、103例、62例;血管狭窄或闭塞部位:颅外动脉、颅内动脉、颅内外动脉分别为25例、86例、230例;责任血管的确定:其中颅外动脉狭窄或闭塞多发于颅内动脉起始部,颅内以大脑中动脉和颅内动脉虹吸部为主,颅内外以颈内动脉起始部、大脑中动脉、颅内动脉虹吸部、椎动脉颅内段间串联为主;血管狭窄程度越重,Hcy水平、高Hcy血症发生频率越高(P<0.05)。结论 血清Hcy水平与CTA诊断结果中血管狭窄程度呈正相关,预计血清Hcy水平在判断血管狭窄程度中有一定的应用价值。

Objective To analyze the relationship between serum homocysteine(Hcy)level and vascular stenosis degree of cerebral infarction diagnosed by CT angiography(CTA).Methods 378 patients with cerebral infarction treated at our hospital from February,2016 to February,2017 were enrolled into this study and were given CTA and serum Hcy test.The CTA results were counted;and the relationship between Hcy and vascular stenosis degree of cerebral infarction diagnosed by CTA was analyzed.Results There were 341 cases of vascular stenosis or occlusion detected by CTA in the 378 patients,with a detection rate of 90.21%.85 cases got light vascular stenosis,91 cases moderate,103 cases severe,and 62 cases occlusion.25 cases had vascular stenosis or occlusion in extracranial artery,86 cases in intracranial artery,and 230 cases in intracranial and extracranial arteries.The determination of offending vessels showed that the extracranial artery stenosis or occlusion mainly happened in the initial part of intracranial artery;the intracranial part was mainly in middle cerebral artery and intracranial artery siphon;and the intracranial and extracranial part was mainly in the initial part of intracranial artery,middle cerebral artery and intracranial artery siphon and intracranial vertebral artery.The more serious the vascular stenosis degree was,the higher the Hcy level and the incidence of hyperhomocysteinemia were(P<0.05).Conclusions Serum Hcy level positively correlates with vascular stenosis degree of cerebral infarction diagnosed by CTA.Serum Hcy level may have a certain value in determining vascular stenosis degree.