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目的初步探讨血浆总同型半胱氨酸(t Hcy)水平与腔隙性脑梗死患者颈动脉搏动指数(PI)的关系。方法选取腔隙性脑梗死患者90例和对照组30例,利用化学发光微粒子免疫检测法检测患者血浆t Hcy水平;借助脑血管功能检测仪测定两侧颈动脉血流运动学参数,包括颈动脉最大血流速度(Vmax)、最小血流速度(Vmin)、平均血流速度(Vmean);利用公式求得PI,PI=(Vmax-Vmin)/Vmean。结果腔隙性脑梗死组患者血浆t Hcy自然对数值(lnt Hcy)与颈动脉搏动指数自然对数值(ln PI)呈正相关(r=0.326,P=0.002),与Vmax、Vmin、Vmean、Qmean均呈负相关(相应r=-0.283,P=0.007;r=-0.417,P=0.000;r=-0.389,P=0.000;r=-0.261,P=0.013),而对照组无此相关性。回归分析显示,血浆t Hcy水平是PI大小的影响因素。结论血浆t Hcy水平和颈动脉PI之间有显著的相关性,血浆t Hcy可能诱导脑部小动脉血管的循环障碍,从而促进腔隙性脑梗死的发生。
Objective To investigate the relationship between plasma total homocysteine (t Hcy) and carotid pulsatility index (PI) in patients with lacunar infarction. Methods Totally 90 patients with lacunar infarction and 30 patients with control group were enrolled in this study. Plasma tHcy levels were measured by chemiluminescence microparticle immunoassay. The hemodynamics parameters of carotid arteries were measured by cerebrovascular function detector, including carotid artery The maximum blood flow velocity (Vmax), the minimum blood flow velocity (Vmin), the average blood flow velocity (Vmean); using the formula to obtain PI, PI = (Vmax-Vmin) / Vmean. Results There was a positive correlation between lnc Hcy and ln PI of patients with lacunar infarction (r = 0.326, P = 0.002), but not with Vmax, Vmin, Vmean, Qmean (R = -0.283, P = 0.007; r = -0.417, P = 0.000; r = -0.389, P = 0.000; r = -0.261, P = 0.013), but not in the control group . Regression analysis showed that the plasma t Hcy level is the influencing factor of PI size. Conclusions There is a significant correlation between plasma tHcy level and carotid artery PI. Plasma tHcy may induce circulatory disturbance of cerebral arterioles and promote lacunar infarction.