影像学指导下同型半胱氨酸与脑梗死TOAST分型的相关性

Homocysteine and correlation TOAST subtypes of cerebral infarction

目的结合影像学检查探讨脑梗死患者血浆同型半胱氨酸(Hcy)水平与TOAST分型之间有无相关性。方法结合影像学表现,将736例脑梗死患者按照TOAST分型标准进行亚型分型,大动脉粥样硬化型333例,小动脉闭塞型374例,心源性栓塞9例,其他病因型11例,不明原因型9例,按照性别进行分组,分别测定Hcy水平与TOAST分型亚型的相关性。结果心源性栓塞型、其他病因型、不明原因型3个亚组样本太小,差异无统计学意义;男性大动脉粥样硬化组Hcy水平高于小动脉闭塞组(13.65±9.65μmol/L vs 11.27±5.52μmol/L),差异有统计学意义(P<0.05)。结论整体患者中Hcy水平与TOAST分型不具有相关性。从性别来看,男性脑梗死患者中,更高的血浆Hcy水平更可能通过促进大动脉粥样硬化进而引起脑梗死。

Objective To investigate the correlation between plasma homocysteine(Hcy)level and TOAST classification in patients with cerebral infarction by imaging examination.Methods A total of 736 cerebral infarction patients were subtypes according to the TOAST classification standard based on imaging,including 333 cases of large atherosclerosis,374 cases of small artery occlusion,9 cases of cardiogenic embolism,11 cases of other etiological type and 9 cases of unknown cause,which were grouped according to gender.The correlation between Hcy level and TOAST subtypes were determined separately.Results The samples of the three subgroups of cardiogenic embolism type,other etiology type and unknown cause type were too small to have statistical significance.The level of Hcy in male large atherosclerosis group was significantly higher than that in small artery occlusion group(13.65±9.65μmol/L vs 11.27±5.52μmol/L,P<0.05).Conclusion There is no significant correlation between Hcy level and TOAST score in the overall patients.According to gender analysis,Hcy level is significantly correlated with large atherosclerosis group in male patients with cerebral infarction,suggesting that higher plasma Hcy level in males is more likely to cause cerebral infarction by promoting atherosclerosis of the great arteries.