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目的探讨老年急性脑梗死(acute cerebral infarction ACI)患者血清同型半胱氨酸(homocysteine Hcy)水平与颈动脉粥样硬化的关系。方法采用酶联免疫吸附法(ELISA)检测160例老年ACI患者血清Hcy水平，并根据Hcy水平将ACI分为Hcy正常组(Hcy 20 mol/L)和Hcy升高组(Hcy>20 mol/L)，并对两组 ACI患者进行颈动脉彩色多普勒超声检查,分别观察斑块有无及血管狭窄程度并进行统计学分析。结果 Hcy升高的ACI患者其颈动脉粥样硬化斑块发生率为70%高于Hcy正常的ACI患者(50%P<0.05)。Hcy升高的ACI患者其轻度颈动脉狭窄和中重度狭窄的发生率分别为64%和35%,高于Hcy正常组(33%和9%,P20 mol/L)group. Then, the two group patients was recieved colorultrasonography,which is used to observe the carotid atherosclerosis and the severity of stenosis of the extracranial carotid.And the data was col ected for statistical treatment. Results The rate of carotid atherosclerosis (70%) in high Hcy level groupwere significantly higher than those (50%) in normalHcy level group (P<0.05). The rates of mild carotid stenosis (64%) and themoderate to severe carotid stenosis (35%) in high Hcy level group were also significantly higher than those (33%and 9%, respectively) in normal Hcy level group (P<0. 05). Conclusion The serum Hcy level in the elderly patients with ACI is associated with carotid atherosclerosis.