摘要
目的研究血清同型半胱氨酸（Hcy）水平与颈动脉斑块、脑动脉狭窄之间的关系。方法 2013年1-10月在该院神经内科住院的100例脑缺血患者,经头颅CT血管成像（CTA）检查证实均存在脑动脉狭窄。应用颈动脉彩色多普勒超声检测颈动脉斑块情况,64排能谱CT行CTA检测颅外段血管及颅内段血管狭窄情况,同时测定血清Hcy水平;根据血清Hcy水平差异,将其分为高Hcy组（观察组）52例和正常Hcy组（对照组）48例,比较两组颈部血管斑块的数量和性质,颅内、外段血管狭窄程度。结果血清Hcy水平比较,观察组明显高于对照组,差异有统计学意义（P〈0.05）。观察组斑块检出率为78.85%（41/52）,发现斑块125个;对照组斑块检出率为58.33%（28/48）,发现斑块78个,观察组斑块检出率显著高于对照组,差异有统计学意义（P〈0.05）;观察组不稳定斑块占总斑块数的65.60%（82/125）,对照组占58.33%（45/78）,两组比较,差异有统计学意义（P〈0.05）。观察组颅外段血管狭窄率（80.77%）高于对照组（62.50%）,其中,观察组轻度血管狭窄率（19.23%）低于对照组（25.00%）,中、重度血管狭窄率（36.54%、25.00%）显著高于对照组（20.83%、16.67%）,差异均有统计学意义（P〈0.05）;观察组颅内段血管狭窄率（76.92%）明显高于对照组（52.08%）,其中,观察组轻度血管狭窄率（17.31%）低于对照组（25.00%）,中、重度血管狭窄率（26.92%,32.69%）显著高于对照组（16.67%,10.42%）,差异有统计学意义（P〈0.05）。观察组颅内、外段轻度血管狭窄率均低于对照组,观察组中、重度狭窄率显著高于对照组,差异有统计学意义（P〈0.05）。结论血清Hcy水平与颈动脉斑块及脑动脉狭窄存在相关性,血清Hcy水平越高,颈动脉斑块总数及不稳定斑块数量越多,动脉粥样硬化越严重,脑动脉狭窄发生率及狭窄程度也随之增高。
Objective To study the relationship between homocysteine（Hcy） levels and carotid artery plaques and cerebral artery stenosis. Methods A total of 100 patients with cerebral stenosis,who were hospitalized in Neurology Department of the hospital from January to October of 2013 and diagnosed by brain CT angiography（CTA）,were selected. Carotid plaques were examined by carotid artery color Doppler ultrasound;the 64-slice CT spectrum was detected by CTA on extracranial and intracranial vascular stenosis,and the serum Hcy level was also determined. The 100 patients were divided into high Hcy group（observation group,n=52）and normal Hcy group（control group,n=48） according to the difference of serum Hcy levels,and the comparison was conducted between the two groups on number of carotid plaques and nature,degree of extracranial and intracranial vascular stenosis. Results The observation group was obviously higher than the control group on serum Hcy levels with statistically significant difference（P〈0.05）. The detection rate of plaques in the experiment group was 78.85%（41/52） with 125 plaques found,while the detection rate was 58.33%（28/48）in the control group with 78 plaques found,and the difference between the two groups had statistical significance（P〈0.05）. The unstable plaques accounted for 65.60%（82/125）of the total plaques in the observation group and 58.33%（45/78） in the control group,the difference between the two groups was statistically significant（P〈0.05）. The rate of extracranial vascular stenosis in the observation group（80.77%）was higher than that in the control group（62.50%）,thereinto,the rate of mild vascular stenosis in the observation group（19.23%） was obviously lower than that in the control group（25.00%）,and the rates of medium and serious vascular stenosis in the observation group（36.54%,25.00%） were significantly higher than those in the control group（20.83%,16.67%）,the differences had statistical significance（P〈0.05）. The rate of intracranial vascular stenosis in the observation group（76.92%）was apparently higher than that in the control group（52.08%）,thereinto,the rate of mild vascular stenosis in the observation group（17.31%） was obviously lower than that in the control group（25.00%）,and the rate of medium and serious vascular stenosis in the observation group（26.92%,32.69%）was significantly higher than those in the control group（16.67%,10.42%）,the differences were statistically significant（P〈0.05）. Both the rates of extracranial and intracranial vascular stenosis in the observation group were lower than those in the control group,the rate of serious stenosis in the observation group was remarkably higher than that in the control group,and the differences had statistical significance（P〈0.05）. Conclusion Serum Hcy levels are correlated with cartid and cerebral artery plaques and stenosis,and the higher of serum Hcy levels be-come,the more obviously total number of atherosclerosis plaques,unstable plaques number and carotid plaques will increase,as well as the incidence rate of cerebral artery stenosis and stenosis degree.
出处
《现代医药卫生》
2014年第18期2721-2723,2727,共4页
Journal of Modern Medicine & Health
关键词
脑动脉
缩窄
病理性
高半胱氨酸
颅内动脉硬化
动脉粥样硬化
Cerebral arteries
Constriction
pathologic
Homocysteine
Intracranial arteriosclerosis
Atherosclerosis
