血清同型半胱氨酸与脑梗死患者颈动脉粥样硬化斑块稳定性的关系  

Relationship between the level of serum homocysteine and stability of carotid atherosclerotic plaques in patients with cerebral infarction

作　　者：许寅宏[1] 徐恩[2] 林清原[2] 邱少东[1] 

机构地区：[1]广州医科大学附属第二医院超声科,广东广州510260 [2]广州医科大学附属第二医院神经内科,广东广州510260

出　　处：《中风与神经疾病杂志》2014年第7期603-605,共3页Journal of Apoplexy and Nervous Diseases

基　　金：广东省医学科研基金(A2013277);广州市科信局民生科技重大专项(2012Y2-00027)

摘　　要：目的探讨缺血性脑血管病患者血清同型半胱氨酸的变化与颈动脉斑块稳定性的关系。方法选择脑梗死患者157例,根据颈动脉超声检查分为无斑块组(46例)和斑块组(111例),斑块组又根据斑块性质分为易损斑块组(67例)和稳定斑块组(43例)。检测血清同型半胱氨酸水平,并采用双功能彩色多普勒超声检测颈动脉内膜中层厚度及斑块性质。结果斑块组血清hcy水平高于无斑块组;易损斑块组血清hcy水平高于无斑块组和稳定斑块组,差异有统计学意义(P<0.05)。血清hcy水平与CIMT呈正相关(r=0.171,P=0.032),差异有统计学意义。结论血清同型半胱氨酸不仅与动脉粥样硬化斑块的形成有关,更与斑块稳定性密切相关,Hcy血清浓度的增高可能是易损斑块形成的危险因素。Objective To investigate the relationship between the change of serum homocysteine（Hcy） and stability of carotid atheroselerotic plaques in patients with cerebral infarction. Methods 157 patients who had cerebral infarction were recruited. According to the results of carotid ultrasound, patients were divided into non plaque group （ n = 46 ） and plaque group （ n = 111 ）. Plaque group were further divided into vulnerable plaque group （ n = 67 ） and stabilized plaque group（ n = 43 ） according to the characters of plaque. The serum Hcy was measured. Intima-medial thickness（IMT） and the characters of plaque were examined with Color Doppler Ultrasound. Results The serum Hey of carotid plaque group was higher than that of the non-plaque group. Serum Hey in the vulnerable plaques group was higher than that in the non plaque group and stable plaque group（ P 〈 0.05 ）. Serum Hey in the patients with cerebral infarction was positively correlated with IMT of carotid（ r = 0.171, P = 0.032 ）. Conclusion The serum Hey is not only related to the formation of carotid athero- sclerosis plaque but also closely related to the stability of carotid atherosclerotie plaques in patients with cerebral infarction. The higher level of serum Hcy might be the risk factor of the formation of vulnerable plaque.

关 键 词：脑梗死 血清同型半胱氨酸 颈动脉粥样硬化斑块 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R445.1[医药卫生—临床医学]