CAJ | 학술논문

目的：测量缺血性脑血管病患者的血浆同型半胱氨酸(Hcy)水平与颈动脉粥样硬化斑块程度，探讨两者之间的关系。方法选择325例首次发病且时间<7 d的缺血性脑血管病患者为研究对象，患者颈动脉内-中膜厚度(IMT)采用颈动脉彩色多普勒超声检测，根据超声结果将患者分为IMT正常组96例、IMT增厚组42例和斑块组187例(非易损组107例，易损组80例)；对患者晨起空腹血浆的Hcy浓度采用酶联免疫吸附法测定。探讨血浆Hcy水平与颈动脉粥样硬化斑块之间的关系。结果颈动脉粥样硬化程度越高， Hcy浓度和高同型半胱氨酸血症(HHcy)发生率越高。IMT增厚组与斑块组间HHcy发生率差异无统计学意义(P>0.05)，组间Hcy水平比较，差异有统计学意义(P<0.05)；易损组血浆Hcy浓度和HHcy发生率高于非易损组，差异均有统计学意义(P<0.05)；多因素分析表明Hcy浓度增高是颈动脉粥样硬化斑块形成的独立危险因素。结论颈动脉粥样硬化程度随着血浆Hcy水平的升高而升高，二者存在正相关关系。
목적：측량결혈성뇌혈관병환자적혈장동형반광안산(Hcy)수평여경동맥죽양경화반괴정도，탐토량자지간적관계。방법선택325례수차발병차시간<7 d적결혈성뇌혈관병환자위연구대상，환자경동맥내-중막후도(IMT)채용경동맥채색다보륵초성검측，근거초성결과장환자분위IMT정상조96례、IMT증후조42례화반괴조187례(비역손조107례，역손조80례)；대환자신기공복혈장적Hcy농도채용매련면역흡부법측정。탐토혈장Hcy수평여경동맥죽양경화반괴지간적관계。결과경동맥죽양경화정도월고， Hcy농도화고동형반광안산혈증(HHcy)발생솔월고。IMT증후조여반괴조간HHcy발생솔차이무통계학의의(P>0.05)，조간Hcy수평비교，차이유통계학의의(P<0.05)；역손조혈장Hcy농도화HHcy발생솔고우비역손조，차이균유통계학의의(P<0.05)；다인소분석표명Hcy농도증고시경동맥죽양경화반괴형성적독립위험인소。결론경동맥죽양경화정도수착혈장Hcy수평적승고이승고，이자존재정상관관계。
ObjectiveTo measure plasma homocysteine (Hcy) level and carotid atherosclerostic plaque degree in ischemic cerebrovascular disease patients, and to investigate the relationship between them. MethodsThere were 325 ischemic cerebrovascular disease patients with first onset <7 d, as study subjects. Inteima-media thickness (IMT) was detected by carotid artery color Doppler ultrasound. Patients were divided by their ultrasound results into normal IMT group with 96 cases, incrassation IMT group with 42 cases and plaque group with 187 cases (vulnerable group with 107 cases and vulnerable group with 80 cases). Enzyme linked immunosorbent assay was applied to detect fasting plasma Hcy. Investigation was made on relationship between plasma Hcy level and carotid atherosclerostic plaque.ResultsHigh degree of atherosclerosis led to high Hcy level and incidence of hyperhomocysteinemia (HHcy). There was no statistically significant difference of incidence of HHcy between incrassation IMT group and plaque group (P>0.05), while the Hcy level differences between these two groups had statistical significance (P<0.05). The vulnerable group had higher plasma Hcy level and incidence of HHcy than the invulnerable group, and their differences all had statistical significance (P<0.05). Multivariate analysis showed that increased Hcy level was the independent risk factor for carotid atherosclerotic plaque.ConclusionDegree of atherosclerosis increases along with increased plasma Hcy level. There is a positive correlation between them.