目的:分析脑梗死合并颈动脉狭窄病变患者血清同型半胱氨酸(Hcy)水平和颈部血管超声结果相关性。方法:选取2015-01-2016-01我院接诊的100例脑梗死患者为脑梗死组,另选取同期来我院体检的100例健康者为对照组。脑梗死组给予脑心通与脉络宁治疗。比较2组颈动脉狭窄情况、斑块形成情况和颈总动脉内膜厚度。测定并比较2组血清Hcy水平和各血液指标甘油三酯(TG)、总胆固醇(TCHO)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)。分别对比对照组和观察组不同狭窄程度患者生化指标。分析脑梗死组患者的临床治疗效果,比较脑梗死组患者治疗前后相关血液指标。结果:对照组狭窄发生率为11.00%,脑梗死组狭窄发生率为82.00%,2组颈动脉狭窄情况比较差异有统计学意义(P<0.05)。对照组斑块发生率为3.00%,脑梗死组斑块发生率为72.00%,2组比较差异有统计学意义(P<0.05)。脑梗死组高Hcy血症发生率明显高于对照组(P<0.05)。脑梗死组颈总动脉膜厚度、Hcy水平、TG、TCHO和LDL-C水平明显高于对照组(P<0.05)。对照组中的无狭窄者和轻度狭窄者的斑块发生率、颈总动脉膜厚度、Hcy水平、TG、TCHO、LDL-C及HDL-C水平比较差异均有统计学意义(P<0.05)。随着狭窄程度的增加,脑梗死组患者的斑块发生率和Hcy血症发生率升高,中度、重度狭窄者、全闭塞者与无狭窄者和轻度狭窄者比较,差异有统计学意义(P<0.05)。重度狭窄者和完全闭塞者的斑块发生率、高Hcy血症发生率、颈总动脉膜厚度、Hcy水平、TG和LDL-C水平均明显高于中度狭窄者(P<0.05)。完全闭塞者和重度狭窄者的颈总动脉膜厚度、Hcy、TG和LDL-C水平比较,差异有统计学意义(P<0.05)。100例脑梗死组患者中,基本治愈57例,显效23例,好转14例,无效6例,治疗总有效率为94.00%(94/100)。脑梗死组治疗后PT、aPTT和TT较治疗前延长,Fbg较治疗前下降显著,脑梗死组患者治疗前后相关血液指标差异具有统计学意义(P<0.05)。结论:脑梗死合并颈动脉狭窄病变和血清Hcy水平关系密切,合并症患者的Hcy水平显著升高,颈部血管超声可明确患者狭窄病变程度,临床应用意义明显。脑心通与脉络宁治疗后患者的疗效显著。 Objective: To analyze the correlation between serum homocysteine ​​(Hcy) level and cervical vascular ultrasound in patients with cerebral infarction and carotid artery stenosis. Methods: Selected 100 cases of cerebral infarction admitted to our hospital from January 2015 to January 2016 were selected as the cerebral infarction group. The other 100 healthy subjects who were examined in our hospital during the same period were selected as the control group. Cerebral infarction group given Naoxintong and Mailuoning treatment. Carotid artery stenosis, plaque formation and carotid intima-media thickness were compared between the two groups. The levels of serum Hcy and the blood parameters of triglyceride (TG), total cholesterol (TCHO), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were measured and compared. The biochemical indexes of different degree of stenosis in control group and observation group were compared respectively. Analysis of clinical treatment of patients with cerebral infarction effect, compared with cerebral infarction patients before and after treatment of blood indicators. Results: The incidence of stenosis was 11.00% in the control group and 82.00% in the cerebral infarction group. There was significant difference between the two groups in the stenosis of carotid artery (P <0.05). The incidence of plaque in control group was 3.00%, and the incidence of plaque in cerebral infarction group was 72.00%. There was significant difference between the two groups (P <0.05). The incidence of Hcy in cerebral infarction group was significantly higher than that in control group (P <0.05). The common carotid artery thickness, Hcy level, TG, TCHO and LDL-C in cerebral infarction group were significantly higher than those in control group (P <0.05). There were significant differences in plaque incidence, carotid artery membrane thickness, Hcy level, TG, TCHO, LDL-C and HDL-C levels between patients without stenosis and mild stenosis in the control group (P <0.05 ). With the increase of the degree of stenosis, the incidence of plaque and the incidence of Hcymia increased in patients with cerebral infarction, moderate and severe stenosis, total occlusion were compared with those without stenosis and mild stenosis, the difference was statistically significant Significance (P <0.05). Plaque incidence, hyperhomocysteinemia, carotid artery membrane thickness, Hcy level, TG and LDL-C levels in patients with severe stenosis and complete occlusion were significantly higher than those with moderate stenosis (P <0.05). The total carotid artery thickness, Hcy, TG and LDL-C levels in patients with complete occlusion and severe stenosis were significantly different (P <0.05). Of 100 patients with cerebral infarction, 57 were cured, 23 were markedly effective, 14 were improved, 6 were ineffective, and the total effective rate was 94.00% (94/100). The levels of PT, aPTT and TT in cerebral infarction group were longer than those before treatment, Fbg decreased significantly compared with those before treatment. There were significant differences in the blood indexes before and after treatment in cerebral infarction group (P <0.05). Conclusion: There is a close relationship between cerebral infarction complicated with carotid artery stenosis and serum Hcy level. The Hcy level in patients with comorbidities is significantly increased. Cervical vascular ultrasound can confirm the degree of stenosis in patients and has obvious clinical significance. Naoxintong and Mailuoning treatment of patients with significant effect.