高同型半胱氨酸血症与急性脑血管病及颈动脉狭窄的关系  

THE RELATIONSHIP BETWEEN HYPERHOMOCYSTEINEMIA AND ACUTE CEREBROVASCULAR DISEASE AND CAROTID STENOSIS

作　　者：李军[1] 沈志梅[2] 朱艳[1] 杨扬[1] 赵海宁[1] 王晓铃[3] 

机构地区：[1]江苏省苏北人民医院神经内科,江苏扬州225001 [2]江苏省苏北人民医院老年科,江苏扬州225001 [3]江苏省苏北人民医院中心实验室,江苏扬州225001

出　　处：《实用临床医药杂志》2006年第6期38-40,46,共4页Journal of Clinical Medicine in Practice

摘　　要：目的研究高同型半胱氨酸血症(HHcy)与急性脑血管病及颈动脉狭窄的关系。方法应用荧光定量分析法测定68例急性脑梗死(ACI组)、52例急性脑出血(AICH组)患者血浆同型半胱氨酸(Hcy)浓度,放免方法测定各组的叶酸、维生素B12水平,并与正常对照组比较。对脑梗死患者采用彩色多普勒超声进行颈动脉检测。结果ACI组、AICH组的血浆Hcy水平均显著高于正常对照组(均P<0.01),而叶酸、维生素B12水平均显著低于正常对照组(均P<0.05)。单因素相关分析显示ACI组、AICH组血浆Hcy水平与叶酸水平均呈负相关(r=-0.37、-0.34,P<0.01),与维生素B12水平也均呈负相关(r=-0.33、-0.29,P<0.01)。ACI组中,颈动脉重度狭窄者血浆Hcy浓度显著高于中度狭窄者及无狭窄或轻度狭窄者(均P<0.01),中度狭窄者血浆Hcy浓度显著高于无狭窄或轻度狭窄者(P<0.01)。结论HHcy是急性脑血管病的一个新的重要危险因素。Hcy水平受叶酸、维生素B12的影响,Hcy水平与脑梗死患者颈动脉狭窄的严重程度有关。Objective To study the relationship between hyperhomocysteinemia（HHcy） and acute cerebrovascular disease and carotid stenosis. Methods Plasma homocysteine （Hcy） levels were measured by fluorescence quantitative assay, and plasma folate and VitB12 concentrations were detected by radioimmune assay of 68 patients with acute cerebral infarction（ACI group）, 52 patients with acute intracerebral hemorrhage（AICH group） and 30 normal subjects. Carotid was assessed using doppler ultrasongraphy in the ACI group. Results The levels of Hcy in ACI group and ACH group were significantly higher than those in normal control group（all P〈 0.01）, and the levels of folic acid and VitB12 were significantly lower than those in normal control group （ all P 〈 0.05）. Both in ACI group and ACH group, the levels of Hcy were negatively related with folic acids（ r = - 0.37, - 0.34, all P〈0.01）, and were negatively related with VitBl2（ r = - 0.33, - 0.29, all P 〈0.01）. In the ACI group, the levels of Hcy in patients with severe carotid stenosis were significantly higher than those in patients with moderated carotid stenosis and mild carotid stenosis or without carotid stenosis（all P 〈 0.01）, and the levels of Hcy in patients with moderated carotid stenosis were significantly higher than those in patients with mild carotid stenosis or without carotid stenosis（P〈0.01）. Conclusion HHcy may be a new and an important risk factor for acute cerebrovascular disease. The level of Hcy was influnced by plasma folate and VitB12, and it was correlated with the severity of carotid stenosis in patients with cerebral infarction.

关 键 词：急性脑血管病 同型半胱氮酸 叶酸 维生素B12 颈动脉狭窄 

分 类 号：R743.3[医药卫生—神经病学与精神病学]