同型半胱氨酸与急性脑梗死患者颈动脉斑块的关系

Relationship between homocysteine and carotid plaque in patients with acute cerebral infarction

目的探讨血清同型半胱氨酸(Hcy)水平与急性脑梗死患者颈动脉斑块的关系。方法选取抚州市第一人民医院2018年5月~2020年2月收治的86例急性脑梗死患者为试验组(无颈动脉斑块者16例,有颈动脉斑块者70例,其中易损斑块者42例,稳定斑块者28例),选取同期于抚州市第一人民医院行常规体检的50例健康者为对照组。采集两组的静脉血,测定血清Hcy水平。比较不同组别Hcy水平差异,观察有无颈动脉斑块及易损斑块与稳定斑块急性脑梗死患者的Hcy水平差异,急性脑梗死患者Hcy水平与颈动脉内膜中层厚度(IMT)相关性。结果试验组的Hcy水平高于对照组,差异有统计学意义(P<0.05);有颈动脉斑块组的Hcy水平高于无颈动脉斑块组,差异有统计学意义(P<0.05);易损斑块组的Hcy水平高于稳定斑块组,差异有统计学意义(P<0.05);急性脑梗死患者的Hcy水平和颈动脉内膜中层厚度(IMT)成正相关(r=0.278,P<0.05)。结论血清Hcy水平与急性脑梗死发生、颈动脉斑块形成密切相关,其水平升高可反映颈动脉斑块性质,监测血清Hcy水平进展可有效评估患者病情及预后。

Objective To investigate the relationship between serum homocysteine(Hcy)level and carotid plaque in patients with acute cerebral infarction.Methods A total of 86 patients with acute cerebral infarction admitted to the First People′s Hospital of Fuzhou City from May 2018 to February 2020 were selected as the experimental group(16 cases without carotid plaque,70 cases with carotid plaque,and 42 cases with vulnerable plaque,28 cases with stable plaque),and 50 healthy people who underwent routine physical examination in the First People′s Hospital of Fuzhou City during the same period were selected as the control group.Venous blood was collected and serum Hcy level was measured.The difference of Hcy levels in different groups was compared.The Hcy levels in patients with acute cerebral infarction with or without carotid plaque,vulnerable plaque and stable plaque were observed,and the correlation between Hcy level and carotid intima-media thickness(IMT)in patients with acute cerebral infarction was observed.Results The level of Hcy in the experimental group was higher than that in the control group,the difference was statistically significant(P<0.05).The level of Hcy in the carotid plaque group was higher than that in the non carotid plaque group,the difference was statistically significant(P<0.05).The level of Hcy in the vulnerable plaque group was higher than that in the stable plaque group,the difference was statistically significant(P<0.05).The level of Hcy in patients with acute cerebral infarction was positively correlated with IMT(r=0.278,P<0.05).Conclusion The level of serum Hcy is closely related to the occurrence of acute cerebral infarction and the formation of carotid plaque.The increase of serum Hcy level can reflect the nature of carotid plaque.Monitoring the progress of serum Hcy level can effectively evaluate the condition and prognosis of patients.