贵州医科大学学报

2014, v.39;No.171(06) 851-853

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高同型半胱氨酸血症对急性脑梗死患者脑血管的影响
Effects of Hyperhomocysteinemia on Cerebral Vascular of Acute Cerebral Infarction Patients

张新勇;文成才;刘冬梅;柳勇;
ZHANG Xinyong;WEN Chengcai;LIU Dongmei;LIU Yong;Department of Neurology,the Second People's Hospital of Huaian;Department of Radiology,the Second People's Hospital of Huaian;

摘要(Abstract):

目的:分析高同型半胱氨酸血症(HHcy)对急性脑梗死患者脑血管的影响。方法:将156例急性脑梗死患者根据静脉血同型半胱氨酸水平分为两组,高同型半胱氨酸血症组(HHcy组)和正常同型半胱氨酸组(n Hcy组)。两组均采用美国国立卫生研究所脑卒中评分(NIHSS)评估患者的神经功能缺损程度;CT脑血管造影(CTA)检测血管异常情况,利用图像后处理技术观察脑血管狭窄情况,分析同型半胱氨酸与神经功能缺损程度以及脑血管狭窄程度的关系。结果:与n Hcy组比较,HHcy组患者的NIHSS评分与静脉血同型半胱氨酸水平更高,差异有统计学意义(P<0.05);HHcy组脑血管异常率大于n Hcy组,差异有统计学意义(P<0.05);HHcy组75例血管异常脑梗死患者中共发现161支血管狭窄,n Hcy组62例血管异常脑梗死患者中共发现157支血管狭窄,n Hcy组狭窄以轻度狭窄为主,HHcy组以中、重度狭窄程度及闭塞为主,HHcy组重度狭窄血管比例明显高于n Hcy组,差异有统计学意义(P<0.05)。神经功能缺损评分以及脑血管狭窄程度与静脉血Hcy水平呈正相关(r=0.386,r=0.364)。结论:HHcy对脑血管病变可产生严重影响,HHcy患者易发生脑梗死。
Objective: To influence of hyperhomocysteinemia( HHcy) on the cerebral vascular in patients with acute cerebral infarction. Methods: A total of 156 patients with acute cerebral infarction were assigned into two groups: hyperhomocysteinemia group( HHcy group) and normal homocysteine group( n Hcy group),neurological deficit degrees were evaluated by national institutes of health stroke scale( NIHSS). Cerebral vascular condition was examined with 320-slice CTA,and the image processing technologies were used to observe the cerebrovascular stenosis. The correlation of Hcy levels with neurological deficit degrees and cerebrovascular stenosis degrees were analyzed. Results: NIHSS scores and blood Hcy levels in HHcy group were higher than those in n Hcy group( P < 0. 05). Abnormal rates of cerebral vessels in HHcy group were higher than those in n Hcy group( P < 0. 05). 161 cerebral vessels with stenosis were detected in 75 patients in HHcy group and moderate,severe stenosis or occlusion predominated. 157 cerebral vessels with stenosis were found in 62 patients with normal homocysteine and were mainly mild stenosis,severe stenosis rates in HHcy group were higher than those in n Hcy group( P < 0. 05). Hcy levels were positively correlate with neurological deficit degrees and cerebrovascular stenosis degrees( r = 0. 386,r = 0. 364). Conclusions: High homocysteine level can cause severe effect on cerebral vascular diseases,and HHcy patients are prone to suffer from cerebral infarction.

关键词(KeyWords): 高同种半胱氨酸血症;脑梗塞;血管造影术;血管狭窄;神经功能缺损
hyperhomocysteinemia;cerebral infarction;angiography;vascular stenosis;neurological deficit

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作者(Author): 张新勇;文成才;刘冬梅;柳勇;
ZHANG Xinyong;WEN Chengcai;LIU Dongmei;LIU Yong;Department of Neurology,the Second People's Hospital of Huaian;Department of Radiology,the Second People's Hospital of Huaian;

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