目的 探讨缺血性脑血管病患者高同型半胱氨酸(Hcy)血症与颅内外动脉狭窄的关系。 方法 2007年6月-2009年12月收治缺血性脑血管病患者90例，根据全脑血管造影检查结果分为颅内外动脉狭窄组和颅内外动脉无狭窄组；颅内外动脉狭窄组依狭窄部位分为单纯颅内动脉狭窄组、单纯颅外动脉狭窄组及颅内外动脉均有狭窄组；分析各组同型半胱氨酸的水平。 结果 颅内外动脉狭窄组血浆Hcy水平显著高于颅内外动脉无狭窄组(Plt;0.05)；单纯颅内动脉狭窄组、单纯颅外动脉狭窄组及颅内外动脉均有狭窄组血浆Hcy水平均显著高于颅内外动脉无狭窄组(Plt;0.05)。 结论 高同型半胱氨酸血症是颅内外动脉狭窄的危险因素，是单纯颅内动脉狭窄及单纯颅外动脉狭窄的共同危险因素。
ObjectiveTo explore the concentration of the plasma homocysteine (Hcy) and the relationship with TOAST subtypes in patients with acute cerebral infarction. MethodsA total of 120 patients with acute cerebral infarction (ACI) treated from April 2012 to April 2013 were enrolled into the ACI group.They were classified with Korean TOAST classification as five subtypes:atherothrombosis (AT) type,small artery disease (SAD) type,cardioembolism (CE) type,stroke of other disease (SOD) type,and stroke of undetermined etiology (SUE) type.The plasma Hcy concentrations in each group and in 60 heathy people who were selected into the control group were measured.Furthermore,the relationship between plasma Hcy concentration and their subtypes were analyzed. ResultsThe plasma Hcy level in ACI group was significant higher than that in the control group (P<0.01).The levels of plasma Hcy were much higher in patients with AT,SAD,SOD,and CE than those in the control groups (P<0.01).In different subtypes,AT and SAD subtypes had higher homocysteine concentration than SUD and CE subtypes did.The concentration of Hcy in AT and SAD group had no significant difference. ConclusionACI is related to hyperhomocysteinemia.The plasma Hcy level varies with different TOAST subtypes of ACI,specially elevating in the subtypes of AT and SAD,which may indicate that hyperhomocysteinemia may increase stroke risk through proatherogenic effect and endothelial dysfunction.