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目的观察青年缺血性脑卒中患者血清同型半胱氨酸(homocysteine,Hcy)水平,探讨其与颈动脉硬化的相关性。方法青年缺血性脑卒中患者64例,对照组为与脑血管病无关的同期住院患者50例,所有研究对象测空腹血糖(FBS)、血脂及Hcy水平,并应用彩色多普勒超声检测其颈动脉。比较脑卒中组与对照组、颈动脉硬化组与颈动脉正常组血清Hcy水平变化。结果脑卒中组和对照组血清Hcy水平升高者分别有38例和8例,占59.38%和16%;血清Hcy水平分别为(17.07±7.68)μmol/L和(10.12±3.27)μmol/L,2组比较差异有统计学意义(P均<0.001)。脑卒中组中伴颈动脉粥样硬化的患者Hcy水平明显高于无颈动脉粥样硬化者(P<0.05)。脑卒中患者Hcy水平与血脂无相关性,与颈动脉内膜中层厚度(inti mal—media thickness,I MT)呈显著正相关性(r=0.824,P<0.001)。结论高Hcy血症可能是青年缺血性脑卒中的重要独立危险因素之一,与早发性颈动脉粥样硬化的形成有关。测定血清Hcy水平和颈部血管彩超检查有助于其早期诊断和防治。
Objective To observe the serum level of homocysteine (Hcy) in young patients with ischemic stroke and to explore its relationship with carotid atherosclerosis. Methods Sixty-four patients with ischemic stroke were enrolled in this study. The control group consisted of 50 hospitalized patients with no history of cerebrovascular disease. All subjects were tested for fasting plasma glucose (FBS), lipids and Hcy levels, and color Doppler ultrasound Carotid artery. The changes of serum Hcy level in stroke group and control group, carotid atherosclerosis group and normal carotid artery group were compared. Results Serum Hcy levels in stroke group and control group were 38 and 8, accounting for 59.38% and 16%, respectively. Serum Hcy levels were (17.07 ± 7.68) μmol / L and (10.12 ± 3.27) μmol / L There was significant difference between the two groups (all P <0.001). Hcy levels in patients with stroke were significantly higher than those without carotid atherosclerosis (P <0.05). The level of Hcy in stroke patients was not correlated with lipids, but positively correlated with carotid intima-media thickness (I MT) (r = 0.824, P <0.001). Conclusions Hyperhomocysteinemia may be one of the important independent risk factors for ischemic stroke in young people, which is related to the formation of early-onset carotid atherosclerosis. Determination of serum Hcy levels and neck vascular color Doppler ultrasound examination contribute to its early diagnosis and prevention.