文章摘要
孔勇,王莹,刘海超,王培福.血清同型半胱氨酸在脑梗死急性期及颈动脉粥样硬化斑块形成中的作用[J].中国临床保健杂志,2018,21(6):757-760.
血清同型半胱氨酸在脑梗死急性期及颈动脉粥样硬化斑块形成中的作用
The role of serum homocysteine in acute cerebral infarction and carotid atherosclerotic plaque formation
投稿时间:2018-06-17  
DOI:10.3969/J.issn.1672-6790.2018.06.009
中文关键词: 脑梗死  半胱氨酸  斑块,动脉粥样硬化  危险因素
英文关键词: Brain infarction  Cysteine  Plaque,atherosclerotic  Risk factors 〖FL
基金项目:
作者单位E-mail
孔勇 航天中心医院神经内科,北京 100049 rerereff@163.com 
王莹 北京航天总医院神经内科  
刘海超 航天中心医院神经内科,北京 100049  
王培福 航天中心医院神经内科,北京 100049 pfuw@sina.com 
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中文摘要:
      目的 研究血清同型半胱氨酸(Hcy)水平在脑梗死急性期及颈动脉粥样硬化斑块形成中的作用。方法 选取200例脑梗死患者为研究对象,根据患者病情分为急性发作组(A组)120例,恢复期组(B组)80例。另取同期健康体检者100例设为健康对照组。采用罗氏Modular P800型全自动生化分析仪通过酶循环法分别检测三组人员的血清Hcy水平。同时彩色多普勒超声检测仪检测三组患者的颈动脉粥样硬化斑块形成情况;并分别检测A组患者入院后治疗第1天、3天、7天、14天、21天、30天后的血清Hcy水平。结果 A组患者血清Hcy水平高于B组以及健康对照组,而B组患者又高于健康对照组,差异均有统计学意义(P均<0.05);A组患者入院后第1天、3天、7天、14天、21天、30天的血清Hcy水平与入院时比较,呈逐渐下降趋势,差异均有统计学意义(P均<0.05);A组无斑块组患者的血清Hcy水平低于单发斑块组与多发斑块组,而单发斑块组又低于多发斑块组,差异均有统计学意义(P均<0.05)。经Spearman秩次等级相关性分析可得:血清Hcy水平与脑梗死急性期时间呈负相关关系,而与颈动脉粥样硬化斑块形成均呈正相关。斑块组吸烟史、糖代谢异常、高血压病史人数占比均明显高于无斑块组,且三酰甘油(TG)、总胆固醇(TC)以及低密度脂蛋白胆固醇(LDL-C)水平均明显高于无斑块组,差异均有统计学意义(均P<0.05)。经多因素logistic回归分析可得,吸烟史、糖代谢异常、高血压病史、TG、TC以及LDL-C均是影响颈动脉粥样硬化斑块形成的危险因素(均P<0.05)。结论 血清Hcy水平与脑梗死的发生、发展密切相关,且随着血清Hcy水平逐渐升高,患者颈动脉粥样硬化程度越严重。
英文摘要:
      Objective To study the role of serum homocysteine (Hcy) in the formation of cerebral infarction acute stage and carotid atherosclerotic plaque. Methods A total of 200 cerebral infarction patients were selected as the research object,and were divided into acute group (group A 120 cases),convalescence group (group B 80 cases).In the same period,100 cases of healthy people from physical examination were recorded as control group.The serum homocysteine levels of the three groups were detected by the enzyme circulation method with the Roche Standard P800 Automatic Biochemical Analyzer.At the same time,the formation of carotid atherosclerotic plaques was detected of the three groups.In addition,the serum homocysteine levels of 1 d,3 d,7 d,14 d,21 d and 30 d after admission were detected. Results The serum Hcy level in group A was higher than that in group B and control group,while group B was higher than control group,and the difference was statistically significant (all P<0.05).In group A,serum Hcy levels of 1 d,3 d,7 d,14 d,21 d and 30 d after admission declined gradually,with statistically significant differences (all P<0.05).The serum Hcy level of group A patients with no patch group was lower than that of the single patch group and the multiple patch group,while the single patch group was lower than that of the multiple group,and the difference was statistically significant (all P<0.05).By Spearman rank correlation analysis,the serum Hcy level was negatively correlated with the acute phase of cerebral infarction,and was positively correlated with carotid atherosclerotic plaque formation.Smoking history,abnormal glucose metabolism,hypertension accounted rate of plaque group were significantly higher than non plaque group,and triglyceride (TG),serum total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) levels were significantly higher than non plaque group,the differences were statistically significant (P<0.05).Multivariate Logistic regression showed that smoking history,glucose metabolism disorder,a history of hypertension TG,TC,and LDL-C were the risk factors of carotid atherosclerotic plaque (P<0.05). Conclusion The serum homocysteine levels is closely associates with the occurrence and development of cerebral infarction,the degree of carotid atherosclerosis increased with the serum homocysteine levels.
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