高同型半胱氨酸血症与进展性缺血性脑卒中相关性的临床研究  

Relationship between hyperhomocysteinemia and progressive ischemic stroke

作　　者：王靖东[1] 吴承志[1] 吕晓侠[1] 董少军[1] 马锐[1] 

机构地区：[1]安徽省淮北矿工总医院神经内科,安徽淮北235000

出　　处：《中风与神经疾病杂志》2009年第1期55-57,共3页Journal of Apoplexy and Nervous Diseases

摘　　要：目的研究血清同型半胱氨酸(Hcy)水平与进展性缺血性脑卒中发生及其与颈动脉粥样硬化(AS)的关系。方法收集88例进展性缺血性脑卒中患者(进展组)、112例非进展性缺血性脑卒中患者(对照组)血液标本,采用荧光偏振免疫法测定Hcy,同时对患者进行血压、空腹血糖、血脂和纤维蛋白原测定及颈动脉彩色超声检查,比较进展组与对照组血清Hcy水平变化,对进展组作血清Hcy水平与颈动脉内膜中层厚度(IMT)相关分析。结果进展组和对照组血清Hcy水平升高分别有62例和43例,占70.45%和38.39%,血清Hcy水平分别为22.65±11.29μmol/L和15.43±6.23μmol/L,两组比较差异有统计学意义(P<0.001)。进展组Hcy水平与颈动脉IMT呈显著正相关性(r=0.691,P<0.001)。结论高Hcy血症与进展性缺血性脑卒中的发生密切相关,与颈动脉粥样硬化及斑块形成有关,为防治发生进展性缺血性脑卒中提供新的理论依据。Objective To investigate the relationship between the serum homocysteine （Hcy）level and progressive ischemic stroke （PIS）as well as carotid artery atherosclerosis （AS）. Methods Blood samples were collected from 88 patients with progressive ischemic stroke and 112 without progressive isehemic stroke controls. The concentrations of Hcy were measured by means of fluorescence polarization immunoassay. In the meantime, blood pressure, fast blood sugar （ FBS ）, plasma lipid and fibrinogen （FIB）of all patients were determined. All carotid arteries of all patients were examined with color Doppler ultrasound. The concentrations of Hcy were compared in progressive ischemic stroke group and control group. The correlation between the concentration of Hcys in progressive ischemic stroke group and IMT was analyzed. Results There were 62 cases in progressive ischemic stroke group and 43 cases in control group showed Hcy levels increased respectively, which account for 70.45 % ,38.39 % with serum concentration being 22.65 ± 11.29μmol/L and 15.43 ± 6.23μmol/ L respectively,the difference was significant statistically（P 〈 0.001 ）. The level of serum Hcy in progressive ischemic stroke patients was positively correlated with IMT（ r = 0. 691, P 〈 0.001 ）. Conclusion Hyperhomocysteinemia is closely related to the occurrence of progressive ischemic stroke and is associated with carotid artery atherosclerosis. It provides a new theoretical evidence for the therapy and the prevention of progressive ischemic stroke.

关 键 词：同型半胱氨酸 进展性缺血性脑卒中 颈动脉粥样硬化 

分 类 号：R743.3[医药卫生—神经病学与精神病学]