摘要/Abstract
摘要： 目的 ·探讨老年患者血浆同型半胱氨酸（ homocysteine，HCY）水平与颈动脉粥样硬化之间的关系及其临床意义。方法 ·纳入 99名 65岁及以上住院老年患者，并使用多普勒彩色超声检测双侧颈总动脉的颈动脉内膜中层厚度（ intima-media thickness， IMT）以及颈动脉分叉处的粥样硬化斑块病变。收集空腹静脉血的 HCY及其他相关指标，并根据血浆 HCY水平将患者分为对照组（HCY<15 μmol/L）和高 HCY组（HCY ≥15 μmol/L），比较 2组间的一般临床资料、颈动脉斑块数、斑块厚度、斑块稳定性及颈动脉 IMT。结果 · 2组的颈动脉斑块数（ P0.015）、斑块不稳定患者的比例（ P0.013）、斑块厚度（ P0.001）间差异均有统计学意义。在控制年龄因素后，血浆 HCY水平与颈动脉斑块数（偏相关系数为 0.133，P0.049）、斑块不稳定性（偏相关系数为 0.046， P0.023）、斑块厚度（偏相关系数为 0.119，P0.024）间呈正相关。而 2组间颈动脉 IMT差异无统计学意义（ P0.057）。结论 ·血浆 HCY与颈动脉粥样硬化斑块数、斑块稳定性及斑块厚度之间存在相关性。
关键词: 颈动脉粥样硬化, 同型半胱氨酸, 粥样斑块, 动脉内膜中层厚度
Abstract:
Objective · To study the relationship between homocysteine (HCY) in plasma and carotid atherosclerosis in the elderly patients and its clinical significance. Methods · The intima-media thickness (IMT) of the common carotid arteries and the sclerotic lesions at the carotid arteries bulbs were evaluatedcolor Doppler ultrasonography in 99 elderly in-patients (65 years old or above). Fasting venous blood was drew the patients for the determination of plasma HCY and other indexes. According to the plasma HCY concentration, the patients were divided into two groups, i.e., control group (HCY<15 μmol/L) and high HCY group (HCY ≥ 15 μmol/L). General clinical data, carotid plaque number, plaque thickness, plaque stability and carotid IMT were investigated in the two group of patients. Results · The numbers (P0.015), stability (P0.013) and thickness (P0.001) of carotid plaques between the two groups were significantly different. After balancing the effects of agethe partial correlation analysis, plasma HCY concentration was positively correlated with the number (partial correlation coefficient0.133, P0.049), instability (partial correlation coefficient0.046, P0.023) and thickness (partial correlation coefficient0.119, P0.024) of carotid plaques. Nevertheless, the difference in the IMT of carotid arteries between the two groups was not significant (P0.057). Conclusion · Plasma HCY concentration is correlated with the number, stability and thickness of carotid plaques.
Key words: carotid atherosclerosis, homocysteine (HCY), atheromatous plaque, intima-media thickness (IMT)
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