腔隙性脑梗死合并颈动脉斑块患者血清同型半胱氨酸水平的分析

Analysis of Serum Homocysteine Levels in Patients with Lacunar Cerebral Infarction and Carotid Plaque

目的探讨腔隙性脑梗死合并颈动脉斑块患者血清同型半胱氨酸水平及其临床意义。方法随机选择2019年1月-2020年12月该院收治的70例腔隙性脑梗死合并颈动脉斑块患者,依照其颈动脉彩超诊断情况将其分为3组,其中23例无斑块患者为a组,25例稳定性斑块患者为b组,22例不稳定斑块患者为c组,对3组患者的一般资料进行分析,对比其血清同型半胱氨酸水平,并对3组中血清同型半胱氨酸水平较高的患者比例进行计算分析。结果3组患者在吸烟史、饮酒史、高血压病史、平均年龄、体质量方面,差异无统计学意义(P>0.05);糖尿病史中a组17.39%、b组28.00%及c组50.00%,3组对比,差异有统计学意义(χ^(2)=12.782,P<0.05);3组患者Hcy水平中,a组(13.78±2.97)mmol/L、b组(17.63±2.65)mmol/L、c组(21.32±4.42)mmol/L,3组对比,差异有统计学意义(P<0.05);高Hcy水平所占率中,a组17.39%、b组36.00%、c组59.09%,3组比较,差异有统计学意义(P<0.05)。结论血清Hcy水平变化与腔隙性脑梗死患者粥样硬化严重程度之间存在密切关联性,之间呈正性相关,该指标参与腔隙性脑梗死动脉粥样硬化的病理过程,可作为评估患者疾病严重程度的指示性指标,具有积极的临床使用价值。

Objective To investigate the level of serum homocysteine and its clinical significance in patients with lacunar cerebral infarction complicated with carotid plaque.Methods From January 2019 to December 2020,70 patients with lacunar cerebral infarction combined with carotid artery plaque were randomly selected in the hospital.According to their carotid artery color Doppler ultrasound diagnosis,they were divided into 3 groups.Among them,23 patients with no plaques belonged to group a,25 patients with stable plaques belonged to group b,and 22 patients with unstable plaques belonged to group c.The general data of the 3 groups were analyzed.The level of serum homocysteine were compared,and the proportion of patients with higher serum homocysteine levels in the three groups was calculated and analyzed.Results There was no significant difference in smoking history,drinking history,hypertension history,average age and body mass among the three groups(P>0.05).In the history of diabetes,group A was 17.39%,group B was 28.00%and group C was 50.00%,and the difference between the three groups was statistically significant(χ^(2)=12.782,P<0.05).The levels of Hcy in group A(13.78±2.97)mmol/L,group B(17.63±2.65)mmol/L and group C(21.32±4.42)mmol/L,the difference between the three groups were statistically significant(P<0.05).The proportion of high Hcy level was 17.39%in group A,36.00%in group B and 59.09%in group C.There was significant difference among the three groups(P<0.05).Conclusion There is a close correlation between changes in serum Hcy levels and the severity of atherosclerosis in patients with lacunar infarction,and there is a positive correlation between them.This indicator is involved in the pathological process of atherosclerosis in lacunar cerebral infarction,and can be used as an indicator to assess the severity of the patient's disease.It has positive clinical use value.