Department of Neurology, Fourth Medical Center of Chinese PLA General Hospital, Beijing 100048, China; Department of Neurology, Chinese PLA General Hospital & Medical School of Chinese PLA, Beijing 100853, China.
Center for Brain Disorders Research, Capital Medical University and Beijing Institute for Brain Disorders, Beijing 100069, China.
J Clin Neurosci. 2019 Dec;70:72-78. doi: 10.1016/j.jocn.2019.08.076. Epub 2019 Aug 22.
Atherosclerosis in stroke-related vascular beds is the major cause of stroke. Studies demonstrated that multivascular atherosclerosis is prevalent in stroke patients and those with multivascular plaques had higher risk of recurrent stroke.
This study investigated the relationship between homocysteine and multivascular atherosclerosis in stroke-related vascular beds using magnetic resonance imaging.
Patients with recent ischemic cerebrovascular symptoms were enrolled and underwent three-dimensional magnetic resonance vessel wall imaging for intracranial arteries, extracranial carotid arteries and aortic arch. Traditional risk factors and homocysteine were measured. Presence of multivascular plaques defined as plaques in at least two stroke-related vascular beds on magnetic resonance imaging was determined. The relationship between homocysteine and characteristics of multivascular plaques was determined.
Of 49 enrolled patients (mean age: 56.3 ± 13.8 years; 35 males), 23 had multivascular plaques. Homocysteine (odds ratio, 1.17; 95% confidence interval, 1.02-1.34; p = 0.022) and age (odds ratio, 1.71; 95% confidence interval, 1.22-2.41; p = 0.002) were significantly associated with presence of multivascular plaques. The adjusted associations remained significant (both p < 0.05). In discriminating presence of multivascular plaques, the area-under-the-curve of age, homocysteine and combination of them was 0.79, 0.70 and 0.87 respectively.
Homocysteine is independently associated with stroke-related multivascular plaques and combination of age and homocysteine has stronger predictive value.
血管床中的动脉粥样硬化是中风的主要原因。研究表明，多血管动脉粥样硬化在中风患者中很常见，并且有多血管斑块的患者中风复发的风险更高。
本研究通过磁共振成像研究同型半胱氨酸与与中风相关的血管床中的多血管动脉粥样硬化之间的关系。
招募了近期有缺血性脑血管症状的患者，并对颅内动脉、颅外颈动脉和主动脉弓进行三维磁共振血管壁成像。测量了传统的危险因素和同型半胱氨酸。通过磁共振成像确定至少两个与中风相关的血管床上存在斑块定义为多血管斑块。确定了同型半胱氨酸与多血管斑块特征之间的关系。
在 49 名入组患者（平均年龄：56.3±13.8 岁；35 名男性）中，有 23 名患者有多血管斑块。同型半胱氨酸（比值比，1.17；95%置信区间，1.02-1.34；p=0.022）和年龄（比值比，1.71；95%置信区间，1.22-2.41；p=0.002）与多血管斑块的存在显著相关。调整后的关联仍然显著（均 p<0.05）。在区分多血管斑块的存在时，年龄、同型半胱氨酸和它们的组合的曲线下面积分别为 0.79、0.70 和 0.87。
同型半胱氨酸与中风相关的多血管斑块独立相关，并且年龄和同型半胱氨酸的组合具有更强的预测价值。
