西藏大学学报
西藏大學學報
서장대학학보
Journal of Tibet University
2014年
2期
82~85
,共null页
缺血性脑血管病 颈动脉粥样硬化 高同型半胱氨酸血症
缺血性腦血管病 頸動脈粥樣硬化 高同型半胱氨痠血癥
결혈성뇌혈관병 경동맥죽양경화 고동형반광안산혈증
ischemic stroke;carotid atherosclerosis;hyperhomocysteinemia
目的：探讨急性缺血性脑血管病患者颈动脉粥样硬化（CAA）的发病情况及血浆同型半胱氨酸（plasma homocysteine,pHcy）与CAA的相关性。方法：对179例急性缺血性脑血管病患者进行颈部血管彩色多普勒检查并按动脉硬化程度分组,比较不同程度CAA组患者pHcy水平的变化,记录所有患者年龄、性别、吸烟、饮酒、高血压及糖尿病等传统危险因素以及pHcy、血脂等生化指标。结果：①入选患者颈动脉粥样斑块的发生率为59.2%,颈动脉狭窄发生率为9.5%;②高同型半胱氨酸血症与颈动脉粥样硬化呈显著性相关;③高同型半胱氨酸血症组（Hhcy）不稳定斑块率（50%）大于正常同型半胱氨酸血症组不稳定斑块率（28.97%）,两者比较有统计学意义（P〈0.05）;④脑梗死患者Hhcy率（46.28%）大于短暂性脑缺血发作（TIA）患者Hhcy率（27.59%）,两者比较有统计学意义（P〈0.05）。结论：急性缺血性脑血管病患者颈动脉狭窄的发生率较低,但普遍存在颈动脉粥样斑块,Hhcy是CAA的独立危险因素,可能是不稳定斑块的危险因素。
目的：探討急性缺血性腦血管病患者頸動脈粥樣硬化（CAA）的髮病情況及血漿同型半胱氨痠（plasma homocysteine,pHcy）與CAA的相關性。方法：對179例急性缺血性腦血管病患者進行頸部血管綵色多普勒檢查併按動脈硬化程度分組,比較不同程度CAA組患者pHcy水平的變化,記錄所有患者年齡、性彆、吸煙、飲酒、高血壓及糖尿病等傳統危險因素以及pHcy、血脂等生化指標。結果：①入選患者頸動脈粥樣斑塊的髮生率為59.2%,頸動脈狹窄髮生率為9.5%;②高同型半胱氨痠血癥與頸動脈粥樣硬化呈顯著性相關;③高同型半胱氨痠血癥組（Hhcy）不穩定斑塊率（50%）大于正常同型半胱氨痠血癥組不穩定斑塊率（28.97%）,兩者比較有統計學意義（P〈0.05）;④腦梗死患者Hhcy率（46.28%）大于短暫性腦缺血髮作（TIA）患者Hhcy率（27.59%）,兩者比較有統計學意義（P〈0.05）。結論：急性缺血性腦血管病患者頸動脈狹窄的髮生率較低,但普遍存在頸動脈粥樣斑塊,Hhcy是CAA的獨立危險因素,可能是不穩定斑塊的危險因素。
목적：탐토급성결혈성뇌혈관병환자경동맥죽양경화（CAA）적발병정황급혈장동형반광안산（plasma homocysteine,pHcy）여CAA적상관성。방법：대179례급성결혈성뇌혈관병환자진행경부혈관채색다보륵검사병안동맥경화정도분조,비교불동정도CAA조환자pHcy수평적변화,기록소유환자년령、성별、흡연、음주、고혈압급당뇨병등전통위험인소이급pHcy、혈지등생화지표。결과：①입선환자경동맥죽양반괴적발생솔위59.2%,경동맥협착발생솔위9.5%;②고동형반광안산혈증여경동맥죽양경화정현저성상관;③고동형반광안산혈증조（Hhcy）불은정반괴솔（50%）대우정상동형반광안산혈증조불은정반괴솔（28.97%）,량자비교유통계학의의（P〈0.05）;④뇌경사환자Hhcy솔（46.28%）대우단잠성뇌결혈발작（TIA）환자Hhcy솔（27.59%）,량자비교유통계학의의（P〈0.05）。결론：급성결혈성뇌혈관병환자경동맥협착적발생솔교저,단보편존재경동맥죽양반괴,Hhcy시CAA적독립위험인소,가능시불은정반괴적위험인소。
The incidence of carotid atherosclerosis（CAA）in acute ischemic stroke（AIS） and as well as to the re-lationship between CAA and（Hhcy） was studied. The diameter of common carotid arteries and internal carotid ar-teries on both sides were measured by B-mode ultrasound for 179 AIS suffered patients and they were divided in-to A（normal）,B,C and D groups according to the severity of CAA, and made comparison of changes in pHcy lev-el between various severity of CAA patients. The risk factors were recorded in these patients as well as Hcy andlipid. The incidence of carotid artery plaque and carotid artery stenosis in the selected patients is 59.2 % and9.5%, respectively. There was significant positive correlation between Hhcy and severity of CAA. The probabilityof unstable plaque（50%） in Hhcy group is more than that in the normal group（28.97%）, with P ＆lt;0.05. Hhcy ratein cerebral infarction group（46.28%） is more than that intransient ischemic attack group（27.59 %）, with P ＆lt;0.05. AIS patients with a lower incidence of carrotid artery stenosis, but the prevalence of carotid artery plaquemay be the one of the important causes of AIS. Hhcy is an independent risk factor of CAA and also could be forunstable plaque.
