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目的探讨血浆同型半胱氨酸(Hcy)、血清超敏C-反应蛋白(hs-CRP)水平及颈动脉粥样硬化与老年脑梗死的关系。方法选择120例老年脑梗死患者为病例组,107名健康老年人为对照组,两组年龄及性别相匹配。分别采用微粒子酶免疫分析法(MEIA)及速率散射免疫比浊法(RNIA)检测两组血浆Hcy及血清hs-CRP水平,超声检测颈动脉斑块情况,并测定平均颈动脉内膜-中层厚度(IMT)。结果病例组Hcy、hs-CRP水平、平均颈动脉IMT值及软斑率均显著高于对照组(P均<0.01),且病例组伴颈动脉软斑患者Hcy浓度及hs-CRP水平也明显大于不伴颈动脉软斑患者(P<0.05和P<0.01)。相关分析结果显示,病例组Hcy水平与hs-CRP水平及平均颈动脉IMT值呈正相关(r分别为0.206和0.191,P均<0.05)。结论老年脑梗死患者血浆Hcy、血清hs-CRP水平、平均颈动脉IMT值及软斑率升高,高Hcy、hs-CRP血症及严重颈动脉粥样硬化可能对老年脑梗死发生有协同作用。
Objective To investigate the relationship between plasma homocysteine (Hcy), serum high-sensitivity C-reactive protein (hs-CRP) and carotid atherosclerosis in elderly patients with cerebral infarction. Methods A total of 120 elderly patients with cerebral infarction were selected as the case group and 107 healthy controls as the control group. The age and gender of the two groups were matched. Plasma Hcy and serum hs-CRP levels were measured by MEIA and RNIA respectively. Carotid artery plaque was detected by ultrasound. Mean carotid artery intima-media thickness (IMT). Results The levels of Hcy, hs-CRP, mean carotid artery IMT and soft spot were significantly higher in the case group than those in the control group (all P <0.01), and the Hcy concentration and hs-CRP level were also significantly higher in patients with carotid atherosclerosis Greater than those without carotid soft spot (P <0.05 and P <0.01). Correlation analysis showed that Hcy level was positively correlated with hs-CRP level and mean carotid artery IMT (r = 0.206 and 0.191, all P <0.05). Conclusions Plasma Hcy levels, serum hs-CRP levels, mean carotid IMT and soft spot rates in elderly patients with cerebral infarction may have synergistic effects with high Hcy, hs-CRP levels and severe carotid atherosclerosis .