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目的探讨急性脑梗死患者血清同型半胱氨酸(Hcy)水平与颈动脉粥样硬化程度的关系。方法选择住院确诊为急性脑梗死患者144例,行颈动脉超声多普勒检查,根据颈动脉超声检查的结果分为颈动脉中-重度狭窄组、颈动脉轻度狭窄组、颈动脉内膜正常组,应用微粒子酶联免疫分析法(MEIA)测定Hcy并进行组间比较。结果颈动脉中-重度狭窄组的Hcy水平为(32.69±19.54)μmol/L,高于颈动脉内膜正常组(17.14±4.98)μmol/L和颈动脉轻度狭窄组(24.72±10.53)μmol/L,有非常显著性差异(P﹤0.01)。颈动脉轻度狭窄组和颈动脉内膜正常组血清Hcy水平有显著性差异(P﹤0.05)。各年龄组间狭窄程度无显著性差异,但50岁以上的老年患者颈动脉狭窄率明显高于50岁以下者(P﹤0.01)。结论高Hcy血症可能通过加速动脉粥样硬化而导致脑梗死,血Hcy水平与动脉粥样硬化程度相关,将二者结合起来,对急性脑梗死的预防、治疗及判断预后有重要意义。
Objective To investigate the relationship between serum homocysteine (Hcy) level and carotid atherosclerosis in patients with acute cerebral infarction. Methods A total of 144 hospitalized patients with acute cerebral infarction were enrolled in this study. The carotid artery was diagnosed by Doppler echocardiography. According to the results of carotid ultrasonography, the patients were divided into moderate-severe carotid stenosis group, mild carotid stenosis group, normal carotid artery intima Group, Hcy was determined by microparticle enzyme-linked immunosorbent assay (MEIA) and compared between groups. Results The level of Hcy in the moderate-severe carotid stenosis group was (32.69 ± 19.54) μmol / L, higher than that in the normal carotid artery group (17.14 ± 4.98 μmol / L) and the mild carotid stenosis group (24.72 ± 10.53 μmolol / / L, there is a very significant difference (P <0.01). Serum Hcy levels were significantly different between mild carotid stenosis group and normal carotid artery intima (P <0.05). There was no significant difference in stenosis among all age groups, but carotid stenosis rate in elderly patients over 50 years old was significantly higher than those under 50 years old (P <0.01). Conclusions Hyperhomocysteinemia may result in cerebral infarction by accelerating atherosclerosis. The level of Hcy in serum is related to the degree of atherosclerosis. Combining the two may be of great significance in the prevention, treatment and prognosis of acute cerebral infarction.