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目的测量缺血性脑血管病患者的血浆同型半胱氨酸(Hcy)水平与颈动脉粥样硬化斑块程度,探讨两者之间的关系。方法选择325例首次发病且时间<7 d的缺血性脑血管病患者为研究对象,患者颈动脉内-中膜厚度(IMT)采用颈动脉彩色多普勒超声检测,根据超声结果将患者分为IMT正常组96例、IMT增厚组42例和斑块组187例(非易损组107例,易损组80例);对患者晨起空腹血浆的Hcy浓度采用酶联免疫吸附法测定。探讨血浆Hcy水平与颈动脉粥样硬化斑块之间的关系。结果颈动脉粥样硬化程度越高,Hcy浓度和高同型半胱氨酸血症(HHcy)发生率越高。IMT增厚组与斑块组间HHcy发生率差异无统计学意义(P>0.05),组间Hcy水平比较,差异有统计学意义(P<0.05);易损组血浆Hcy浓度和HHcy发生率高于非易损组,差异均有统计学意义(P<0.05);多因素分析表明Hcy浓度增高是颈动脉粥样硬化斑块形成的独立危险因素。结论颈动脉粥样硬化程度随着血浆Hcy水平的升高而升高,二者存在正相关关系。
Objective To measure the level of plasma homocysteine (Hcy) and the degree of carotid atherosclerotic plaques in patients with ischemic cerebrovascular disease and to explore the relationship between the two. Methods 325 patients with ischemic cerebrovascular disease who were first onset and less than 7 days were enrolled in this study. The carotid intima-media thickness (IMT) was measured by color Doppler ultrasound. According to the results of ultrasound, 96 cases of IMT normal group, 42 cases of IMT thickening group and 187 cases of plaque group (non-vulnerable group of 107 cases, vulnerable group of 80 cases); early morning plasma Hcy concentrations were measured by enzyme-linked immunosorbent assay . To investigate the relationship between plasma Hcy and carotid atherosclerosis plaque. Results The higher the degree of carotid atherosclerosis, the higher the incidence of Hcy and hyperhomocysteinemia (HHcy). There was no significant difference in the incidence of HHcy between IMT thickening group and plaque group (P> 0.05), and the difference of Hcy between groups was statistically significant (P <0.05). The plasma Hcy concentration and the incidence of HHcy in vulnerable group (P <0.05). Multivariate analysis showed that the increased concentration of Hcy was an independent risk factor for the formation of carotid atherosclerosis plaque. Conclusions The degree of carotid atherosclerosis increases with the increase of plasma Hcy, and there is a positive correlation between them.