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目的探讨血浆同型半胱氨酸水平与脑大动脉狭窄程度的相关性。方法选择行全脑数字减影血管造影术(DSA)检查的急性缺血性脑卒中患者269例。根据DSA显示动脉狭窄是否≥50%为依据,分为2组:狭窄组(150例)患者颅内、外脑大动脉至少1支血管狭窄率≥50%;对照组(119例)患者无狭窄或狭窄<50%。检测两组血浆同型半胱氨酸(Hcy)水平,按Hcy值分4个水平(≤11.8μmol/L、11.9-14.1μmol/L、14.2-17.1μmol/L、≥17.2μmol/L)观察血管狭窄≥50%的发生率。进行多因素logistic回归分析。结果狭窄组血浆Hcy水平明显高于对照组。随着血浆Hcy水平升高,脑大动脉粥样硬化狭窄≥50%的发生率逐渐增加(分别为48.6%、53.7%、53.8%、67.2%)。血浆Hcy水平升高是脑大动脉粥样硬化狭窄的独立危险因素(OR=1.071,95%CI:1.004-1.142,P=0.036)。结论 Hcy升高与脑大动脉狭窄程度密切相关,降低血浆Hcy水平与控制其它危险因素同样重要。
Objective To investigate the correlation between the plasma homocysteine level and the degree of cerebral stenosis. Methods A total of 269 patients with acute ischemic stroke who underwent whole brain digital subtraction angiography (DSA) were enrolled. According to whether DSA showed arterial stenosis≥50% or not, the patients were divided into two groups: the stenosis group (150 cases) had stenosis rate of at least 1 vessel in the intracranial and extra-cerebral aorta≥50%; the control group (119 cases) Narrow <50%. Plasma homocysteine (Hcy) level was measured in two groups. Blood vessels were observed at 4 levels (≤11.8μmol / L, 11.9-14.1μmol / L, 14.2-17.1μmol / L, and ≥17.2μmol / L) Stenosis ≥ 50% incidence. Multivariate logistic regression analysis. Results The level of Hcy in the stenosis group was significantly higher than that in the control group. As plasma Hcy levels increased, the incidence of cerebral atherosclerotic stenosis ≥50% increased (48.6%, 53.7%, 53.8%, 67.2%, respectively). Plasma Hcy levels were an independent risk factor for cerebral atherosclerosis (OR = 1.071, 95% CI: 1.004-1.142, P = 0.036). Conclusion The increase of Hcy is closely related to the degree of stenosis of cerebral aorta. Reducing plasma Hcy level is just as important as controlling other risk factors.