血浆同型半胱氨酸水平与颈部动脉粥样硬化患者脑梗死复发的相关性研究
顾媛媛;冯来会;
摘要(Abstract):
目的探讨血浆同型半胱氨酸(homocysteine,Hcy)水平与颈动脉粥样硬化患者复发性脑梗死的关系。方法颈动脉粥样硬化患者160例,根据脑梗死发生次数,分为脑梗死复发组52例,脑梗死初发组54例,无脑梗死或脑出血对照组54例;检测并比较各组血浆Hcy的水平及颈动脉粥样硬化斑块类型。结果脑梗死复发组及初发组血浆Hcy水平和高同型半胱氨酸血症(HHcy)发生率均显著高于对照组(P<0.01),脑梗死复发组血浆Hcy水平和HHcy发生率亦显著高于脑梗死初发组(P<0.05);脑梗死复发组易损斑块发生率显著高于脑梗死初发组(88.5%比64.8%,P<0.05);脑梗死组检出易损斑块患者的血浆Hcy水平显著高于硬斑块患者[(28.96±7.01)μmol/L比(23.56±6.98)μmol/L,P<0.05]。结论血浆Hcy水平与颈动脉粥样硬化患者易损斑块的形成及脑梗死的复发可能相关。
关键词(KeyWords): 脑梗死;颈动脉粥样硬化;复发;同型半胱氨酸
基金项目(Foundation):
作者(Authors): 顾媛媛;冯来会;
参考文献(References):
- [1]Huang HW,Guo MH,Lin RJ,et al.Hyperhomocysteinemia is a risk factor of middle cerebral artery stenosis[J].J Neurol,2007,254(3):364-367.
- [2]Ni M,Zhang XH,Jiang SL,et al.Homocysteinemia as an inde-pendent risk factor in the Chinese population at a high risk of coronary artery disease[J].Am J Cardiol,2007,100(3):455-458.
- [3]Speidl WS,Nikfardjam M,Niessner A,et al.Mild hyperho-mocysteinemia is associated with a decreased fibrinolytic activi-ty in patients after ST-elevation myocardial infarction[J].Thromb Res,2007,119(3):331-336.
- [4]李秋萍,华扬援颈动脉粥样硬化的超声检测与临床相关性研究进展[J].中国脑血管病杂志,2009,6(6):317-321.
- [5]Touboul PJ,Hennerici MG,Meairs S,et al.Mannheim carot-id intima-media thickness consensus(2004-2006).An update on behalf of the Advisory Board of the3rd and4th Watching the Risk Symposium,13th and15th European Stroke Confer-ences,Mannheim,Germany,2004,and Brussels,Belgium,2006[J].Cerebrovasc Dis,2007,23(1):75-80.
- [6]Naghavi M,Libby P,Falk E,et al.From vulnerable plaque tovulnerable patient:a call for new definitions and risk assess-ment strategies:PartⅠ[J].Circulation,2003,108(14):1664-1672.
- [7]Tan NC,Venketasubramanian N,Saw SM,et al.Hyperhomo-cyst(e)inemia and risk of ischemic stroke among young Asian adults[J].Stroke,2002,33(8):1956-1962.
- [8]Dahl A,Lund C,Russell D.Atherosclerosis and cerebral infarc-tion[J].Tidsskr Nor Laegeforen,2007,127(7):892-896.
- [9]Paraskevas KI,Hamilton G,Mikhailidis DP.Statins:an es-sential component in the management of carotid artery disease[J].J Vasc Surg,2007,46(2):373-386.
- [10]Sen U,Mishra PK,Tyagi N,et al.Homocysteine to hydrogen sulfide or hypertension[J].Cell Biochem Biophys,2010,57(2/3):49-58.
- [11]胡大一,徐希平.有效控制“H型”高血压-预防卒中的新思路[J].中华内科杂志,2008,47(12):976-977.
- [12]Homocysteine Studies Collaboration.Homocysteine and risk of ischemic heart disease and stroke:a meta-analysis[J].JA-MA,2002,288(16):2015-2022.
- [13]Clarke R,Halsey J,Lewington S,et al.Effects of lowering homocysteine levels with B vitamins on cardiovascular dis-ease,cancer,and cause-specific mortality:Meta-analysis of8 randomized trials involving37485individuals[J].Arch Intern Med,2010,170(18):1622-1631.
- [14]Wang X,Qin X,Demirtas H,et al.Efficacy of folic acid sup-plementation in stroke prevention:a meta-analysis[J].Lan-cet,2007,369(9576):1876-1882.