脑梗死患者颈动脉内膜中层厚度及血管重构与同型半胱氨酸、D-二聚体水平的关系

The relationship betweenthe carotid intima-media thickness and vascular remodeling and the levels of HCY and D-dimer in patients with cerebral infarction

目的探讨脑梗死患者颈动脉内膜中层厚度(IMT)及血管重构与同型半胱氨酸(HCY)、D-二聚体(DD)水平的关系。方法我院收治的脑梗死患者115例为研究组,同期80例健康体检者为对照组,利用超声测定IMT及斑块情况,采用免疫法测定Hcy水平、酶联免疫吸附试验(ELISA)法测定DD水平。比较两组Hcy和DD水平,分析其与IMT和血管重构的关系。结果两组血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)和低密度脂蛋白(LDL)水平比较,差异无统计学意义(P>0.05)。研究组HCY和DD水平均高于对照组,IMT和血管重构指数(RI)均大于对照组(P<0.05)。年龄、吸烟史、LDL、HCY和DD均为IMT的影响因素(P<0.05);HCY和DD水平与IMT呈正相关(P<0.05)。结论在脑梗死高危患者中可将Hcy和DD作为独立危险因子预测颈动脉血管重构和IMT增厚;关注HCY和DD水平,有利于延缓颈动脉粥样硬化的进展和降低心血脑疾病发生率。

Objective To investigate the relationship of the carotid intima-media thickness(IMT)and vascular remodeling and the levels of homocysteine(HCY)and D-dimer(D-D)in patients with cerebral infarction.Methods One hundred and fifteen patients with cerebral infarction(experiment group),and 80 healthy individuals(control group)were enrolled in this study.The carotid IMT and plaques were measured by ultrasound.Meanwhile,immunoassay was used to measure HCY level,and enzyme-linked immunosorbent assay(ELISA)was used to measure D-D level.The levels of Hcy and D-D were compared between the two groups,and their relationship with carotid IMT and vascular remodeling was analyzed.Results There was no significant difference in levels of serum total cholesterol(TC),triacylglycerol(TG),high-density lipoprotein(HDL)and low-density lipoprotein(LDL)between the two groups(P>0.05).The HCY and D-D levels in the experiment group were significantly higher than those in the control group(P<0.05).The carotid IMT and vascular remodeling index(RI)in the experiment groupwere higher than those in the control group(P<0.05).Multiple linear stepwise regression analysis found that age,smoking history,LDL,HCY and D-D were related to IMT value(P<0.05).Pearson correlation analysis showed that HCY and D-D levels were positively correlated with IMT(P<0.05).Conclusion HCY and D-D can be used as independent risk factors to predict carotid artery remodeling and IMT in patients with high-riskcerebral infarction.Paying attention to the levels of HCY and D-D will help delay the progression of carotid atherosclerosis and reduce the incidence of heart,blood and brain diseases.