天津医药

• 临床研究 • 上一篇    下一篇

脑梗死患者同型半胱氨酸与颈动脉内膜中层厚度的关系

王渝1,张哲成1,朱炬1,张静2,王素红1,金凤艳3,杨新忠4,田丽1   

  1. 1. 天津市第三中心医院
    2. 天津市第三中心医院神经内科
    3. 天津市第三中心神经内科
    4. 天津市第三中心医院脑内
  • 收稿日期:2014-01-17 修回日期:2014-04-25 出版日期:2014-09-15 发布日期:2014-09-15
  • 通讯作者: 王渝

The Relationship between Homocysteine and Carotid Intima-media Thickness in Brain Infarction Patients

  • Received:2014-01-17 Revised:2014-04-25 Published:2014-09-15 Online:2014-09-15
  • Contact: Yu Wang

PDF (PC)

2734

摘要：

【摘要】目的探讨脑梗死患者血浆总同型半胱氨酸（tHcy）与颈动脉内膜中层厚度（CIMT）的关系。方法从急性脑梗死住院患者中选取tHcy 水平≤10μmol/L（非Hhcy组）、tHcy 水平>10μmol/L且≤15μmol/L（H1组）、tHcy 水平>15μmol/L（H2组）的患者各60例，测量3组患者CIMT，并检测三酰甘油（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、空腹血糖（FBS）、叶酸（FA）、维生素B12 （VitB12）、糖化血红蛋白（HbA1c）等临床生化指标。结果3组患者CIMT差异有统计学意义（P<0.01），其中H2组[0.98（0.90,1.05）mm ]与非 Hhcy组[0.85（0.80,0.95）mm]、H2组与H1组[0.85（0.85,0.95）mm]比较均增加（均P<0.05）。3组患者tHcy、FA、VitB12 水平差异有统计学意义。以CIMT的常用对数为因变量进行多重线性逐步回归分析，结果显示年龄增长、吸烟史、糖尿病史、LDL-C升高、tHcy升高与CIMT增加有关。结论伴有tHcy水平升高的脑梗死患者常有FA、VitB12水平降低，CIMT增加，且当tHcy 水平>15μmol/L时CIMT明显增加，脑梗死患者CIMT增加与部分脑血管病危险因素有关。

关键词: 高同种半胱氨酸血症, 脑梗死, 颈动脉, 动脉粥样硬化, 超声检查, 多普勒, 叶酸, 维生素B12

Abstract:

[Abstract] Objective To investigate the relationship between total homocysteine (tHcy) and carotid intima-media thickness (CIMT) in brain infarction patients. Methods Sixty patients with fasting plasma tHcy levels≤10μmol/L (nonHhcy group),60patients with fasting plasma tHcy levels >10μmol/L and≤15μmol/L (H1group), and60patients with fast? ing plasma tHcy levels >15μmol/L (H2group) were chosen in hospitalized patients with acute cerebral infarction. Values of CIMT were detected in three groups of patients. The clinical biochemical indicators including triglyceride (TG), total choles? terol (TC), high density lipoprotein cholesterol (HDL- C), low density lipoprotein cholesterol (LDL- C), fasting blood sugar (FBS), folic acid (FA), Vitamin B12 (VitB12) and glycated hemoglobin (HbA1c) were also detected.Results There was signifi? cant difference in CIMT between three groups (P<0.01). The value of CIMT increased in H2group [0.98(0.90, 1.05)mm] com? pared with that of non-Hhcy group [0.85(0.80, 0.95)mm]. The value of CIMT increased in H2group compared with H1group [0.98(0.90, 1.05)mm vs0.85(0.85, 0.95)mm], P<0.05). There were significant differences in tHcy, FA and VitB12 between three groups. Based on the log-transformed values of CIMT as the dependent variable, multiple stepwise linear regression showed significant associations of the following variables with increased CIMT: increasing age, the history of smoking, the history of diabetes, higher LDL-C and tHcy levels.Conclusion Brain infarction in patients with higher tHcy level often have lower levels of FA and VitB12, and increased CIMT. When the level of tHcy >15μmol/L, there is more significantly higher level of CIMT. The increased CIMT level was associated with some cerebrovascular risk factors in patients with brain infarction

Key words: hyperhomocysteinemia, brain infarction, carotid arteries, atherosclerosis, ultrasonography, doppler, folic acid, 维生素B12