高同型半胱氨酸血症与急性脑血管病及颈动脉狭窄的关系李军1,沈志梅2,朱艳1,杨扬1,赵海宁1,王晓铃3(江苏省苏北人民医院,1.神经内科,2.老年科,3.中心实验室,江苏扬州,225001)摘要:目的研究高同型半胱氨酸血症(HHcy)与急性脑血管病及颈动脉狭窄的关系。方法应用荧光定量分析法测定68例急性脑梗死(ACI组)、52例急性脑出血(AICH组)患者血浆同型半胱氨酸(Hcy)浓度,放免方法测定各组的叶酸、维生素B12水平,并与正常对照组比较。对脑梗死患者采用彩色多普勒超声进行颈动脉检测。结果ACI组、AICH组的血浆Hcy水平均显著高于正常对照组(均P<0.01),而叶酸、维生素B12水平均显著低于正常对照组(均P<0.05)。单因素相关分析显示ACI组、AICH组血浆Hcy水平与叶酸水平均呈负相关(r=-0.37、-0.34,P<0.01),与维生素B12水平也均呈负相关(r=-0.33、-0.29,P<0.01)。ACI组中,颈动脉重度狭窄者血浆Hcy浓度显著高于中度狭窄者及无狭窄或轻度狭窄者(均P<0.01),中度狭窄者血浆Hcy浓度显著高于无狭窄或轻度狭窄者(P<0.01)。结论HHcy是急性脑血管病的一个新的重要危险因素。Hcy水平受叶酸、维生素B12的影响,Hcy水平与脑梗死患者颈动脉狭窄的严重程度有关。关键词:急性脑血管病;同型半胱氨酸;叶酸;维生素B12;颈动脉狭窄中图分类号:R74313文献标识码:A文章编号:1672Ο2353(2006)06Ο0038Ο03THERELATIONSHIPBETWEENHYPERHOMOCYSTEINEMIAANDACUTECEREBROVASCULARDISEASEANDCAROTIDSTENOSISLIJun1,SHENZhiΟmei2,ZHUYan1,YANGYang1,ZHAOHaiΟning1,WANGXiaoΟling3(1.DepartmentofNeurology,2.DepartmentofGerontology,3.CentralLaboratory,SubeiPeople′sHospitalofJiangsu,Yangzhou,Jiangsu,225001)ABSTRACT:ObjectiveTostudytherelationshipbetweenhyperhomocysteinemia(HHcy)andacutecerebrovasculardiseaseandcarotidstenosis.MethodsPlasmahomocysteine(Hcy)levelsweremeasuredbyfluorescencequantitativeassay,andplasmafolateandVitB12concentrationsweredetectedbyradioimmuneassayof68patientswithacutecerebralinfarction(ACIgroup),52patientswithacuteintracerebralhemorrhage(AICHgroup)and30normalsubjects.Carotidwasassessedus2ingdopplerultrasongraphyintheACIgroup.ResultsThelevelsofHcyinACIgroupandACHgroupweresignificantlyhigherthanthoseinnormalcontrolgroup(allP<0.01),andthelevelsoffolicacidandVitB12weresignificantlylowerthanthoseinnormalcontrolgroup(allP<0.05).BothinACIgroupandACHgroup,thelevelsofHcywerenegativelyrelatedwithfolicacids(r=-0.37,-0.34,allP<0.01),andwerenegativelyrelatedwithVitB12(r=-0.33,-0.29,allP<0.01).IntheACIgroup,thelevelsofHcyinpatientswithseverecarotidstenosisweresignifi2cantlyhigherthanthoseinpatientswithmoderatedcarotidstenosisandmildcarotidstenosisorwithoutcarotidstenosis(allP<0.01),andthelevelsofHcyinpatientswithmoderatedcarotidstenosisweresignificantlyhigherthanthoseinpatientswithmildcarotidstenosisorwithoutcarotidstenosis(P<0.01).ConclusionHHcymaybeanewandanimportantriskfactorforacutecere2brovasculardisease.ThelevelofHcywasinfluncedbyplasmafolateandVitB12,anditwascorrelat2edwiththeseverityofcarotidstenosisinpatientswithcerebralinfarction.KEYWORDS:acutecerebrovasculardisease;homocysteine;folate;VitB12;carotidstenosis收稿日期:2006-05-26作者简介:李军(1965-),男,江苏扬州人,副教授、副主任医师。实用临床医药杂志·38·JournalofClinicalMedicineinPractice2006年第10卷第6期©1994-2008ChinaAcademicJournalElectronicPublishingHouse.Allrightsreserved.http://www.cnki.net近年来,随着新的检验技术出现和分子生物学的发展,人们对同型半胱氨酸(homocysteine,Hcy)代谢异常与脑血管病的关系有了更多认识。越来越多的研究认为,高Hcy血症(HHcy)同高血压、糖尿病、高血脂、吸烟等危险因素一样,是心脑血管病的一个独立危险因素[1Ο4]。作者测定了68例急性脑梗死(ACI组)、52例急...
