血浆同型半胱氨酸与脑卒中高危人群颈动脉粥样硬化的关系1材料和方法.DOCVIP

血浆同型半胱氨酸与脑卒中高危人群颈动脉粥样硬化的关系 孟媛媛，吴德云 (胜利油田中心医院 神经内科，山东 东营 257034) 【摘要】 目的 通过对东营市社区居民颈动脉粥样硬化发生及相关因素进行抽样调研，了解脑卒中高危人群中颈动脉粥样硬化与血浆同型半胱氨酸的关系。方法：选择东营市胜利街道辖区2012年9月-2012年12月期间参加东营市脑卒中筛查项目、≥40岁居民10500名。筛选出脑卒中高危人群1381名，对其进行问卷调查，并进行血糖、血脂、同型半胱氨酸、颈动脉超声检查。结果：1. 1381名脑卒中高危人群中107人有ITM增厚；731人有粥样斑块形成，其中易损板块组（544人），稳定性板块组（187人）。2. 随着颈动脉病变程度的加重，1381例脑卒中高危人群中的HHcy发病率及血浆Hcy浓度均逐渐增加(X 2=157.15，P0.05)。其中与IMT正常组相比，IMT增厚组及斑块形成组的HHcy发病率及血浆Hcy浓度均显著增加（(P0.05)，与IMT增厚组比较，斑块形成组HHcy发病率差异无统计学意义。（P0.05）。3. 易损斑块HHcy发病率及血浆Hcy浓度均高于稳定斑块组，差异有统计学意义（P0.05）。4.多因素Logistic回归分析显示，Hcy浓度增高是颈动脉粥样硬化斑块的独立危险因素。结论：随着血浆Hcy水平的升高，颈动脉粥样硬化程度随之升高。HHcy是颈动脉粥样硬化斑块形成及斑块易损性的独立危险因素。 【关键词】脑卒中；颈动脉粥样硬化；同型半胱氨酸；超声检查 Relationship between plasma homocysteine and carotid atherosclerotic plaques in residents with high risk of stroke Meng Yuanyuan,Wu Deyun (Department of Neurology,The Central Hospital of Shengli Oil Field, Dongying Shandong 257034,China) Abstract:【Objective】 To investigate the relationship between plasma homocysteine level and carotid atherosclerotic (CAS) plques by researching the incidence of CAS and its associated factors among the comminity residents of Dongying.【Method】 Cllected 10500 more than 40 years old residents who participate the stroke screening programe in Dongying community from Sseptember to October in 2012.1381 subjects with high risk of stroke were obtained ,Date were collected by using stsndard questionnaires.Each subject was asked to have the following examination :blood lipid,blood lucose, plasma homocysteine,carotid color ultrasound.【Results】 1.Of the 1381 patients,107 were IMTthikening, and 731 were atherosclerotic plaque formation.Of the 731 patients with atherosclerotic plaque formation,544 were in the vulnerable plaque group and 187 were in the non-vulnerable plaque group.2.With the increasing of carotid artery stenosis degree, The incidences of plasma Hcy level and Hhcy in the stroke high risk group were increased(X 2=157.15，P0.05). The incidences of plasma Hcy level and Hhcy in IMTthikening group