老年急性动脉粥样硬化性脑血栓患者外周血同型半胱氨酸的变化及临床价值

Changes and clinical value of peripheral blood homocysteine in elderly patients with acute atherosclerotic cerebral thrombosis

目的:探究老年急性动脉粥样硬化性脑血栓患者外周血同型半胱氨酸的变化。方法:收治老年急性动脉粥样硬化性脑血栓患者120例,同时选取健康体检的人群110例作对照。检查两组外周血同型半胱氨酸和各项生化指标,测量患者的颈总动脉内中膜厚度。结果:对照组外周血同型半胱氨酸、超敏C反应蛋白和总胆固醇水平都明显低于观察组(P<0.05)。有颈动脉粥样硬化斑块的患者同型半胱氨酸水平明显高于无颈动脉粥样硬化斑块的患者(P<0.05),重度患者、中度患者与轻度患者的同型半胱氨酸水平呈递减趋势。据此可知,血浆同型半胱氨酸高低水平与脑梗死病情程度呈正相关,血浆同型半胱氨酸高低水平与患者颈动脉内中膜厚度呈正相关。结论:老年急性动脉粥样硬化性脑血栓患者的外周血同型半胱氨酸水平升高,而且其升高水平与患者的疾病程度呈正相关关系,该指标可作为治疗老年急性动脉粥样硬化性脑血栓疾病的病情监测指标和疗效监测指标。

Objective:To explore the changes of homocysteine in peripheral blood of elderly patients with acute atherosclerotic cerebral thrombosis.Methods:120 elderly patients with acute atherosclerotic cerebral thrombosis were selected,and 110 healthy people were selected as controls.The peripheral blood homocysteine and biochemical indexes were examined in both groups,and the intima-media thickness of common carotid artery was measured.Results:The levels of homocysteine,hypersensitive C-reactive protein and total cholesterol in peripheral blood of the control group were significantly lower than those of the observation group(P<0.05).The level of homocysteine in patients with carotid atherosclerotic plaque was significantly higher than that in patients without carotid atherosclerotic plaque(P<0.05),homocysteine levels in severe,moderate and mild patients showed a decreasing trend,it can be concluded that the level of plasma homocysteine is positively correlated with the severity of cerebral infarction,and the level of plasma homocysteine is positively correlated with carotid intima-media thickness in patients with cerebral infarction.Conclusion:The level of homocysteine in peripheral blood of elderly patients with acute atherosclerotic cerebral thrombosis is increased,and the level of homocysteine is positively correlated with the severity of the disease,this conclusion can be used as a disease monitoring index and therapeutic effect monitoring index for the treatment of elderly patients with acute atherosclerotic cerebral thrombosis.