Ma Yuetao, Zhao Xingquan, Zhang Wei, Liu Liping, Wang Yilong, Fang Ruile, Wang Yongjun
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China.
Neurol Res. 2010 Jul;32(6):636-41. doi: 10.1179/016164109X12445616596445. Epub 2009 Aug 5.
Elevated homocysteine level is a risk factor for ischemic stroke and associated with small vessel disease such as confluent leukoaraiosis in white and black population. We investigated the relationship between the total serum homocysteine level and ischemic stroke subtypes in Chinese population.
Three hundred and seventy-seven acute ischemic stroke and 106 transient ischemic attack patients were consecutively enrolled into this study. Demographic information and traditional risk factors were collected. Stroke subtypes were classified using the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria. Leukoaraiosis was graded from 0 to 3 according to the severity. Small vessel disease patients were further categorized into two subgroups of having or without confluent leukoaraiosis.
The highest homocysteine level was found in small vessel disease patients after adjusting for age, gender, traditional vascular risk factors and renal function. Homocysteine level was significantly different between the ischemic stroke and transient ischemic attack groups. Elevated homocysteine level was significantly correlated with the severity of leukoaraiosis in all patients with stroke and small vessel disease. Small vessel disease patients with leukoaraiosis had significant higher homocysteine levels than those without leukoaraiosis.
In this group of Chinese patients studied, small vessel disease patients with confluent leukoaraiosis had the highest homocysteine levels.
同型半胱氨酸水平升高是缺血性卒中的一个危险因素，并且在白种人和黑种人群中与诸如融合性脑白质疏松症等小血管疾病相关。我们研究了中国人群中血清总同型半胱氨酸水平与缺血性卒中亚型之间的关系。
377例急性缺血性卒中和106例短暂性脑缺血发作患者连续纳入本研究。收集人口统计学信息和传统危险因素。采用急性卒中治疗中Org 10172试验（TOAST）标准对卒中亚型进行分类。根据严重程度将脑白质疏松症分为0至3级。小血管疾病患者进一步分为有或无融合性脑白质疏松症的两个亚组。
在校正年龄、性别、传统血管危险因素和肾功能后，小血管疾病患者的同型半胱氨酸水平最高。缺血性卒中和短暂性脑缺血发作组之间的同型半胱氨酸水平有显著差异。在所有卒中患者和小血管疾病患者中，同型半胱氨酸水平升高与脑白质疏松症的严重程度显著相关。有脑白质疏松症的小血管疾病患者的同型半胱氨酸水平显著高于无脑白质疏松症的患者。
在本研究的这组中国患者中，有融合性脑白质疏松症的小血管疾病患者的同型半胱氨酸水平最高。
