摘要
目的探讨血浆同型半胱氨酸水平与动脉粥样硬化性脑梗死的关系,为动脉粥样硬化性脑梗死的预防提供指导依据。方法选择107例动脉粥样硬化性脑梗死患者为脑梗死组,同时选择同期本院健康体检者76例为对照组。所有研究对象均记录年龄、性别,吸烟、饮酒、高血压、糖尿病等既往史,测定血浆同型半胱氨酸(homocysteine,HCY)水平及空腹血糖(FBG)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C),应用彩色超声多普勒检查患者颈动脉内膜中层厚度(intimal-medial wall thickness,IMT)。根据颈动脉彩色超声多普勒检查结果将脑梗死组分为脑梗死伴颈动脉粥样硬化斑块组和脑梗死无斑块组,将对照组分为对照有颈动脉粥样硬化斑块组和对照无斑块组;脑梗死有斑块组和对照有斑块合并为斑块组,脑梗死无斑块组和对照无斑块组合并无斑块组。结果脑梗死组男性、高龄、吸烟、高血压患者较对照组增多,FBG、血浆TC、LDL-C、HCY水平均高于对照组,差异有统计学意义(P<0.05)。多元Logistic回归分析显示吸烟、高血压、糖尿病、高血浆TC、LDL-C、HCY水平均是动脉粥样硬化性脑梗死的危险因素。Sperman秩相关显示HCY与吸烟、饮酒、高血压、糖尿病、TC、TG、LDL-C均无相关性。脑梗死组血浆HCY水平、IMT均高于对照组,斑块组血浆HCY、IMT水平均高于无斑块组,脑梗死有斑块组血浆HCY、IMT水平均高于脑梗死无斑块组,对照有斑块组血浆HCY、IMT水平均高于对照无斑块组,且差异均有统计学意义(P<0.05);直线相关分析显示血浆HCY水平与IMT水平呈正相关(r=0.86,P<0.05)。结论血浆HCY水平与脑梗死关系密切,高血浆HCY水平是动脉粥样硬化性脑梗死的独立危险因素,高血浆HCY水平主要通过加速动脉粥样硬化影响脑梗死的发病。
Objective To investigate the relationship between plasma homocysteine（HCY） and atherosclerosis cerebral infarction.Methods One hundred and seven patients were chosen for the cerebral infarction（CI） group and seventy-six healthy people for control group.The gender,ages,hypertension,diabetes,smoking and aleohol drinking history were recorded,and the levels of plasma HCY,TC,TG,LDL-C and FBG were measured.The changes of carotid intimal-medial thickness （IMT） were examined by carotid duplex ultrasonography scanning.According to the results of carotid Doppler ultrasongraphy,these patients were re-divided into two subgroups：CI with carotid atherosclerotic plaque and CI without plaque.And the controls were also re-divided into two subgroups：control with carotid atherosclerotic plaque and control without plaque.The CI with carotid atherosclerotic plaque and the control with carotid atherosclerotic plaque were called plaque group.The CI without carotid atherosclerotic plaque and the control without carotid atherosclerotic plaque were called non-plaque group.Results The group of CI had more old man,smoker and more with hypertension than control group （P0.05）.And the FBG and levels of plasma TC,LDL-C,HCY were significantly higher in the group of CI than those in control group （P0.05）.Smoking,hypertensions,diabetes,high level of plasma TC,LCL-C,HCY were the risk factors of the atherosclerosis cerebral infarction.The level of plasma HCY was not correlated with ages,gender,history of smoking,alcohol drinking,hypertension and diabetes.The level of plasma HCY and the IMT were significantly higher in plaque group than those in non-plaque group （P0.05）;The level of plasma HCY and the IMT were significantly higher in the CI with carotid atherosclerotic plaque group than those in the group of CI without plaque （P0.05）;The level of plasma HCY and the IMT were significantly higher in the group of control with carotid atherosclerotic plaque than those in the group of control without plaque （P0.05）;The
出处
《中国实用神经疾病杂志》
2010年第10期3-6,共4页
Chinese Journal of Practical Nervous Diseases
