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目的研究颈部血管超声与同型半胱氨酸检测在脑梗死合并颈动脉狭窄病变中的临床应用价值。方法选取51例脑梗死患者作为实验组,另外选取同一时期的50例健康人作为对照组,两组人群均进行颈部血管超声与同型半胱氨酸(Hcy)检测,比较两组患者的检查结果。结果实验组患者中无狭窄、Ⅰ度狭窄、Ⅱ度狭窄、Ⅲ度狭窄、完全闭塞的发生例数为6、14、17、11、3例,血管狭窄发生率为88.2%;对照组受检者中无狭窄、Ⅰ度狭窄、Ⅱ度狭窄、Ⅲ度狭窄、完全闭塞的发生例数为45、5、0、0、0例,血管狭窄发生率为10.0%;实验组血管狭窄发生率高于对照组,差异有统计学意义(P<0.05)。颈动脉完全闭塞患者的颈动静内膜中膜厚度(IMT)值和同型半胱氨酸水平明显高于无狭窄、Ⅰ度狭窄、Ⅱ度狭窄、Ⅲ度狭窄患者,差异有统计学意义(P<0.05)。结论脑梗死合并颈动脉狭窄病变患者血清同型半胱氨酸水平明显升高,且随着颈动脉狭窄程度的加重,血清同型半胱氨酸水平呈上升趋势。因此联合应用颈部血管超声检查和同型半胱氨酸检测,能够准确的发现是否有狭窄病变存在,为临床治疗提供了较为准确的参考意见。
Objective To study the clinical value of neck vascular ultrasound and homocysteine in the diagnosis of cerebral infarction with carotid artery stenosis. Methods Fifty-one patients with cerebral infarction were selected as the experimental group, and 50 healthy people in the same period were selected as the control group. The neck blood vessels and homocysteine (Hcy) were measured in both groups. The two groups were compared result. Results The patients in the experimental group had no stenosis, Ⅰ degree stenosis, Ⅱ stenosis, Ⅲ degree stenosis. The number of complete occlusion was 6, 14, 17, 11 and 3 cases, and the incidence of stenosis was 88.2%. In the control group, No stenosis, Ⅰ degree stenosis, Ⅱ degree stenosis, Ⅲ degree stenosis, the number of complete occlusion was 45,5,0,0,0 cases, the incidence of vascular stenosis was 10.0%; the incidence of vascular stenosis in the experimental group was high In the control group, the difference was statistically significant (P <0.05). Intima-media thickness (IMT) and homocysteine levels in patients with complete carotid artery occlusion were significantly higher than those in patients with no-stenosis, grade Ⅰ stenosis, grade Ⅱ stenosis and grade Ⅲ stenosis (P <0.05). Conclusion Serum homocysteine levels in patients with cerebral infarction complicated with carotid artery stenosis were significantly increased. Serum homocysteine level increased with the severity of carotid artery stenosis. Therefore, joint application of cervical vascular ultrasound and homocysteine test, can accurately detect the presence of stenosis, clinical treatment provides a more accurate reference.