血清同型半胱氨酸水平与青年缺血性脑卒中的关系  

The Correlation between serum homocysteine level and the occurrence of youth ischemic stroke

作　　者：刘聪[1,2] 童晓欣[1] 

机构地区：[1]北京大学深圳医院神经内科,深圳518036 [2]汕头大学

出　　处：《卒中与神经疾病》2010年第3期166-168,共3页Stroke and Nervous Diseases

摘　　要：目的观察青年缺血性脑卒中患者血清同型半胱氨酸(homocysteine,Hcy)水平,探讨其与颈动脉硬化的相关性。方法青年缺血性脑卒中患者64例,对照组为与脑血管病无关的同期住院患者50例,所有研究对象测空腹血糖(FBS)、血脂及Hcy水平,并应用彩色多普勒超声检测其颈动脉。比较脑卒中组与对照组、颈动脉硬化组与颈动脉正常组血清Hcy水平变化。结果脑卒中组和对照组血清Hcy水平升高者分别有38例和8例,占59.38%和16%;血清Hcy水平分别为(17.07±7.68)μmol/L和(10.12±3.27)μmol/L,2组比较差异有统计学意义(P均<0.001)。脑卒中组中伴颈动脉粥样硬化的患者Hcy水平明显高于无颈动脉粥样硬化者(P<0.05)。脑卒中患者Hcy水平与血脂无相关性,与颈动脉内膜中层厚度(inti mal—media thickness,I MT)呈显著正相关性(r=0.824,P<0.001)。结论高Hcy血症可能是青年缺血性脑卒中的重要独立危险因素之一,与早发性颈动脉粥样硬化的形成有关。测定血清Hcy水平和颈部血管彩超检查有助于其早期诊断和防治。Objective To explore serum homocysteine（Hcy） level in patients with youth ischemic stroke and to discuss the correlation between serum homocysteine level and carotid atherosclerosis.Methods 64 patients with youth ischemic stroke were included into brain stroke group and 50 patients hospitalized during the same period without cerebrovascular diseases into control group.All the study subjects were given detections of fasting blood glucose,blood fat and Hcy level,and their carotid arteries were examined by color Doppler ultrasound.Comparisons of serum Hcy changes were made between the brain stroke group and the control group and between carotid-atherosclerosis group and normal carotid-artery group.Results Elevation of serum Hcy level was shown in 38 patients（59.38%） of the brain stroke group and 8 patients（16%） of the control group.The Hcy levels were （17.07±7.68） μmol/L and（10.12±3.27） μmol/L respectively,suggesting statistically significant difference when comparing these two groups（P0.001）.In the brain stroke group,Hcy level was significantly higher in stroke patients with carotid atherosclerosis than in those without carotid atherosclerosis（P0.05）.Hcy level was irrelevant with blood fat but significantly and positively correlated with the thickness of carotid intimal—media thickness（r=0.824,P0.001）.Conclusions Early carotid atherosclerosis is the main cause of youth ischemic stroke,which should be prevented as early as possible by determining serum Hcy level and scanning cervical blood vessel with color ultrasound for early diagnosis.

关 键 词：同型半胱氨酸 青年缺血性脑卒中 颈动脉粥样硬化 

分 类 号：R743[医药卫生—神经病学与精神病学]