中国循环杂志
中國循環雜誌
중국순배잡지
CHINESE CIRCULATION JOURNAL
2015年
1期
30-33
,共4页
颈部血管超声%同型半胱氨酸%脑梗塞%颈动脉狭窄
頸部血管超聲%同型半胱氨痠%腦梗塞%頸動脈狹窄
경부혈관초성%동형반광안산%뇌경새%경동맥협착
Neck vascular ultrasound%Homocysteine%Cerebral infarction%Carotid stenosis
目的：探讨颈部血管超声与血清同型半胱氨酸（Homocysteine, Hcy）在脑梗塞颈动脉狭窄病变的临床应用价值。<br> 方法：2012-01至2013-12选取115例脑梗塞患者为脑梗塞组，另选取110例健康体检者为对照组，采用血管超声测定各组颈动脉狭窄情况（无狭窄者：狭窄率为0；轻度狭窄者：狭窄率≤29％；中度狭窄者：狭窄率为30％~69％；重度狭窄者：狭窄为70％~99％；完全闭塞者：狭窄为100%）、斑块形成情况及颈总动脉内中膜厚度（Intima-media thickness, IMT）。采用循环酶法测定两组血清Hcy，采用日立全自动化生化分析仪测定两组甘油三酯、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇水平。<br> 结果：脑梗塞组颈动脉血管狭窄发生率高于对照组（89.56％ vs 10.91％），差异有统计学意义（P<0.001）。脑梗塞组与对照组比，斑块发生率（73.91％ vs 6.08％）、IMT水平[（1.85±0.42）mm vs（0.75±0.21）mm]、Hcy水平[（42.32±12.02）μmol/L vs（6.32±2.45）μmol/L]、高Hcy血症发生率（71.30％ vs 3.63％）、甘油三酯[（4.25±1.12）mmol/L vs（1.63±0.74）mmol/L]、低密度脂蛋白胆固醇水平[（5.96±1.36）mmol/L vs（2.32±0.82） mmol/L]均明显增高，两组比较差异均有统计学意义（P均<0.05）。脑梗塞组患者中根据狭窄程度进一步分析可见，完全闭塞者、重度狭窄者的斑块发生率、IMT水平、血清Hcy水平、高Hcy血症发生率、甘油三酯、低密度脂蛋白胆固醇水平均高于轻、中度狭窄者，差异均有统计学意义（P<0.05）。经Logistic分析可知，IMT水平、血清Hcy水平、低密度脂蛋白胆固醇为脑梗塞颈动脉狭窄的独立危险因素。<br> 结论：脑梗塞合并颈动脉狭窄病变患者血清Hcy水平显著升高，且血清Hcy水平与颈动脉狭窄程度相关。
目的：探討頸部血管超聲與血清同型半胱氨痠（Homocysteine, Hcy）在腦梗塞頸動脈狹窄病變的臨床應用價值。<br> 方法：2012-01至2013-12選取115例腦梗塞患者為腦梗塞組，另選取110例健康體檢者為對照組，採用血管超聲測定各組頸動脈狹窄情況（無狹窄者：狹窄率為0；輕度狹窄者：狹窄率≤29％；中度狹窄者：狹窄率為30％~69％；重度狹窄者：狹窄為70％~99％；完全閉塞者：狹窄為100%）、斑塊形成情況及頸總動脈內中膜厚度（Intima-media thickness, IMT）。採用循環酶法測定兩組血清Hcy，採用日立全自動化生化分析儀測定兩組甘油三酯、總膽固醇、低密度脂蛋白膽固醇、高密度脂蛋白膽固醇水平。<br> 結果：腦梗塞組頸動脈血管狹窄髮生率高于對照組（89.56％ vs 10.91％），差異有統計學意義（P<0.001）。腦梗塞組與對照組比，斑塊髮生率（73.91％ vs 6.08％）、IMT水平[（1.85±0.42）mm vs（0.75±0.21）mm]、Hcy水平[（42.32±12.02）μmol/L vs（6.32±2.45）μmol/L]、高Hcy血癥髮生率（71.30％ vs 3.63％）、甘油三酯[（4.25±1.12）mmol/L vs（1.63±0.74）mmol/L]、低密度脂蛋白膽固醇水平[（5.96±1.36）mmol/L vs（2.32±0.82） mmol/L]均明顯增高，兩組比較差異均有統計學意義（P均<0.05）。腦梗塞組患者中根據狹窄程度進一步分析可見，完全閉塞者、重度狹窄者的斑塊髮生率、IMT水平、血清Hcy水平、高Hcy血癥髮生率、甘油三酯、低密度脂蛋白膽固醇水平均高于輕、中度狹窄者，差異均有統計學意義（P<0.05）。經Logistic分析可知，IMT水平、血清Hcy水平、低密度脂蛋白膽固醇為腦梗塞頸動脈狹窄的獨立危險因素。<br> 結論：腦梗塞閤併頸動脈狹窄病變患者血清Hcy水平顯著升高，且血清Hcy水平與頸動脈狹窄程度相關。
목적：탐토경부혈관초성여혈청동형반광안산（Homocysteine, Hcy）재뇌경새경동맥협착병변적림상응용개치。<br> 방법：2012-01지2013-12선취115례뇌경새환자위뇌경새조，령선취110례건강체검자위대조조，채용혈관초성측정각조경동맥협착정황（무협착자：협착솔위0；경도협착자：협착솔≤29％；중도협착자：협착솔위30％~69％；중도협착자：협착위70％~99％；완전폐새자：협착위100%）、반괴형성정황급경총동맥내중막후도（Intima-media thickness, IMT）。채용순배매법측정량조혈청Hcy，채용일립전자동화생화분석의측정량조감유삼지、총담고순、저밀도지단백담고순、고밀도지단백담고순수평。<br> 결과：뇌경새조경동맥혈관협착발생솔고우대조조（89.56％ vs 10.91％），차이유통계학의의（P<0.001）。뇌경새조여대조조비，반괴발생솔（73.91％ vs 6.08％）、IMT수평[（1.85±0.42）mm vs（0.75±0.21）mm]、Hcy수평[（42.32±12.02）μmol/L vs（6.32±2.45）μmol/L]、고Hcy혈증발생솔（71.30％ vs 3.63％）、감유삼지[（4.25±1.12）mmol/L vs（1.63±0.74）mmol/L]、저밀도지단백담고순수평[（5.96±1.36）mmol/L vs（2.32±0.82） mmol/L]균명현증고，량조비교차이균유통계학의의（P균<0.05）。뇌경새조환자중근거협착정도진일보분석가견，완전폐새자、중도협착자적반괴발생솔、IMT수평、혈청Hcy수평、고Hcy혈증발생솔、감유삼지、저밀도지단백담고순수평균고우경、중도협착자，차이균유통계학의의（P<0.05）。경Logistic분석가지，IMT수평、혈청Hcy수평、저밀도지단백담고순위뇌경새경동맥협착적독립위험인소。<br> 결론：뇌경새합병경동맥협착병변환자혈청Hcy수평현저승고，차혈청Hcy수평여경동맥협착정도상관。
Objective:To investigate the clinical value of neck vascular ultrasound and homocysteine (Hcy) level in patients with cerebral infarction and carotid stenosis. <br> Methods: Our research included 2 groups. Cerebral infarction group, n=115 patient who were treated in our hospital from 2012-01 to 2013-12, and Control group, n=110 healthy subjects from physical check-up. Neck vascular ultrasound was conducted to classify the degree of carotid stenosis as ①no stenosis, ②mild degree, the stenosis rate≤29%, ③moderate degree, the stenosis rate at 30%~69%,③severe degree, the stenosis rate at 70%~99%,④complete occlusion. Carotid plaque formation and vascular intima-media thickness (IMT) were examined by neck ultrasound. Blood levels of Hcy and triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) were <br> measured in clinical laboratory. <br> Results: Compared with Control group, Cerebral infarction group had the higher rate of carotid stenosis 89.56%vs 10.91%, more plaque formation 73.91%vs 6.08%and increased IMT (1.85 ± 0.42) mm vs (0.75 ± 0.21) mm;higher blood levels of Hcy (42.32 ± 12.02) μmol/L vs (6.32 ± 2.45) μmol/L and higher rate of high blood Hcy syndrome 71.30%vs 3.63%;higher levels of TC (4.25 ± 1.12) mmol/L vs (1.63 ± 0.74) mmol/L and LDL-C (5.96 ± 1.36) mmol/L vs (2.32 ± 0.82) mmol/L, P<0.05. In Cerebral infarction group, the patients with complete carotid occlusion and severe stenosis had the higher rate of plaque formation and increased IMT;higher levels of Hcy and more high blood Hcy syndrome;higher levels of TG and LDL-C than the patients with mild and moderate carotid stenosis, P<0.05. Logistic analysis indicated that the levels of IMT, Hcy and LDL-C were the independent risk factors for cerebral infarction and carotid stenosis. <br> Conclusion: The patients with cerebral infarction and carotid stenosis have obviously increased blood level of Hcy. Hcy may predict various degree of carotid stenosis in relevant patients.
