急性脑梗塞患者血清同型半胱氨酸与下肢动脉粥样硬化程度的关系.doc

急性脑梗死患者血清同型半胱氨酸水平与下肢动脉粥样硬化程度的关系 季芳 李蕾※ 戚筠＊ 武汉科技大学附属天佑医院 神经内科 摘要 目的 探讨急性脑梗死患者血清同型半胱氨酸（Homocysteine, HCY）水平与下肢动脉粥样硬化程度的关系。方法 选取住院确诊的急性脑梗死患者110例，均行下肢动脉彩超检查，根据下肢动脉超声检查的结果分为无斑块组（27）例、稳定斑块组（45）例和不稳定斑块组（38）例,比较三组之间HCY水平。同时根据HCY测定结果分为HCY低水平组（5-15 umol/L）、HCY中水平组（15-26 umol/L）和HCY高水平组（≥26 umol/L），比较三组间双侧下肢动脉IMT厚度。 结果 不稳定斑块组的HCY水平（36.85±16.86）umol/L高于稳定斑块组（23.74±15.42）umol/L和无斑块组（9.23±6.78）umol/L，差异有统计学意义（P均＜0.001）。高HCY水平组IMT厚度（左1.37±0.74，右1.41±0.73mm）高于低HCY水平组IMT厚度（左0.91±0.58，右0.92±0.46mm），差异有统计学意义(左P=0.001，右P=0.004）。结论 血清HCY水平随着下肢动脉粥样硬化斑块的加重逐渐升高，高HCY水平与动脉粥样硬化斑块的不稳定有关。对急性脑梗死高HCY血症者应积极干预治疗，以防病情进一步恶化。 [关键词] 急性脑梗死 同型半胱氨酸 下肢动脉粥样硬化 The relationship between blood HCY level and lower extremity arteriosclerosis in patients with acute cerebral infarction JI Fang Wang Ya LI Lei Qi Yun Department of Neurology ,The Affiliated Hospital of Wuhan University of Science ﹠Technology, Wuhan 430064,China [Abstract] Objective To investigate the relationship between blood HCY level and lower extremity arteriosclerosis in patients with acute cerebral infarction. Methods The study includes a total of 110 patients with acute cerebral infarction. All patients were examined by color Doppler ultrasonography to detect lower extremity arteriosclerosis. The patients were divided into three groups according to the severity of arteriosclerosis: no plaques group (27 cases), stable plaques group (45 cases) and unstable plaques group (38 cases). The HCY levels were compared among groups and between groups using one-way ANOVA. The HCY level was measured by ELISA. According to measurement results the patients were divided into three groups: low HCY level group(5-15 umol/L) , middle HCY level group(15-26 umol/L) and high HCY level group(≥26 umol/L). Results The blood HCY level of unstable plaques group（36.85±16.86 umol/L） was higher than the stable plaques group (23.74 + 15.42 umol/L) and no plaques group (9.23±6.78 umol/L). The differences were statistica