缺血性脑卒中患者血清同型半胱氨酸水平与颈动脉狭窄程度的相关性研究

Correlation between serum homocysteine levels and carotid stenosis in patients with ischemic stroke

目的:分析血清同型半胱氨酸(Hcy)水平与缺血性脑卒中患者颈动脉狭窄程度的相关性。方法:选取北京平谷医院94例缺血性脑卒中且伴有颈动脉狭窄的患者(观察组),采用彩色多普勒超声对其颈动脉狭窄程度进行检查,其中,轻度狭窄者23例为轻度组,中度狭窄者27例为中度组,重度狭窄者22例为重度组,闭塞者22例为闭塞组。另选择同期于本院体检合格的志愿者40例为对照组。对各组血清低密度脂蛋白(LDL)、总胆固醇(TC)及Hcy的含量进行检测。结果:观察组血清TC、LDL及Hcy含量较对照组均显著升高(均P<0.01)。血清LDL、TC及Hcy的含量在闭塞组中最高,其次是重度组、中度组、轻度组,而对照组的含量最低,各组间比较均存在明显差异(均P<0.05)。血清Hcy的含量与LDL、TC均无显著相关性(r=0.08、0.04,均P>0.05),与颈动脉狭窄程度存在显著相关性(r=0.64,P<0.01)。结论:血清Hcy水平升高可能参与缺血性脑卒中的发病过程,并且其水平与颈动脉狭窄程度存在显著关系。

Objective: To analyze the correlation between serum homocysteine (Hcy) levels and carotid stenosis in patients with ischemic stroke. Methods: Ninety-four patients of ischemic stroke with carotid stenosis (observation group) were selected and undergone colour Doppler ultrasound examination to determine the degree of carotid stenosis in Pinggu Distric hospital. It was shown that 23 cases were with mild stenosis (mild group), 27 with moderate stenosis (moderate group), 22 with severe stenosis (severe group), and 22 with carotid artery occlusion (occlusion group). At the same time, 40 healthy volunteers who received physical examination in the same hospital were selected as the control group. The levels of serum low-density lipoprotein cholesterol (LDL), total cholesterol (TC) and Hcy were detected in each group. Results: The levels of serum LDL, TC and Hcy were obviously higher in observation group than in control group (P<0.01), and was the highest in occlusion group, followed by severe group, moderate group and the mild group, and was the lowest in control group, with all the significant differences (P<0.05). No significant correlation existed between serum Hcy content and LDL, TC (r=0.08, 0.04, P>0.05), but there was a significant correlation between serum Hcy content and the degree of carotid stenosis (r=0.64, P<0.01). Conclusion: The increased serum Hcy levels may be involved in the pathogenesis of ischemic stroke, and the Hcy level has shown a significant relationship with the degree of carotid stenosis.