| Objective To explore the value of serum homocysteine(Hcy) and SPECT cerebral blood flow perfusion imaging in early recognition and diagnosis of ischemic cerebrovascular disease(ICVD) by analyzing the levels of serum Hcy and the characteristics of SPECT cerebral blood flow perfusion imaging in transient ischemic attack(TIA) patients, cerebral infarction patients and normal control group.Methods A total of 42 cases in our hospital with the diagnosis of ICVD were collected from June 2013 to December 2015, aged 54-87(67.25±8.27), including 26 males and 16 females, which were classified as 30 cases of cerebral infarction, aged 56-87(68.59±7.92), and 12 cases of TIA patients, aged 54-76(63.91±8.84). Meanwhile, 30 healthy check-up subjects selected with age and gender matched were collected as control group, aged 49-78(64.17±8.45), including 16 males and 14 females. The levels of serum Hcy were detected and the examination of 99mTc-ECD SPECT cerebral blood flow perfusion imaging was taken to all the research objects. The methods of visual inspection and semi-qualitative analysis were used in SPECT cerebral blood flow perfusion imaging and radioactivity ratio(RAR) between the brain regions and cerebellum was calculated. The changes of regional cerebral blood flow(r CBF) were reflected by RAR. The levels of serum Hcy were compared and the characteristics of cerebral blood flow perfusion images were analyzed by using statistical analysis.Results In ICVD group, the level of male's serum Hcy was 17.32±3.38?mol/L and the female's was 15.09±3.26?mol/L. In control group, the level of male's serum Hcy was 13.16±3.01?mol/L and the female's was 10.12±2.17?mol/L. The level of male's serum Hcy was distinctly higher than that of female's not only in ICVD group but also in control group(P < 0.05). The levels of serum Hcy in cerebral infarction group, TIA group and control group were 17.32±3.48?mol/L, 14.37±2.51?mol/L and 11.74±3.03?mol/L respectively. The level of serum Hcy in cerebral infarction group was evidently higher than that in TIA group and control group(P < 0.05), and it was obviously higher in TIA group than that in control group(P < 0.05). r CBF decreased in both cerebral infarction group and TIA group, and r CBF was normal in control group. The RAR of ischemic area in cerebral infarction group decreased more obviously than that in TIA group and control group(P < 0.05). The RAR of ischemic area in TIA group decreased more apparently than that in control group(P < 0.05). The RAR of ischemic area in both cerebral infarction group and TIA group was lower than the contralateral side(P < 0.05). The RAR had no obvious difference on both sides brain regions in control group(P > 0.05).Conclusions 1. The level of serum Hcy in ICVD group is obviously higher than that in control group, and the level of male's serum Hcy is obviously higher than that of female's not only in ICVD group but also in control group. That pointed out Hcy is one of the risk factors in ICVD, which effects on male patients especially obviously. 2. The level of serum Hcy in cerebral infarction group is obviously higher than that in TIA group and control group, and it is obviously higher in TIA group than that in control group. That reveals the level of serum Hcy is positively related with the severity of ICVD. 3. The RAR of ischemic area in cerebral infarction group decreased more obviously than that in TIA group and control group. The RAR of ischemic area in TIA group decreased more apparently than that in control group. It has obvious relevance between the RAR of brain regions and the severity of ICVD. That is to say, there is synergistic effect between the serum Hcy and SPECT cerebral blood flow perfusion imaging in diagnosis of ICVD. 4. The RAR of bilateral brain regions is same in control group, but the RAR of ischemic area in both cerebral infarction group and TIA group was lower than the contralateral side. In conclusion, the serum Hcy and SPECT cerebral blood flow perfusion imaging can be significantly used in early recognition and diagnosis of ICVD. We should carry out positive and effective interventions in patients with TIA to reduce the risk of worsening,and take effective treatments in patients with cerebral infarction to reduce its disability rate and fatality rate. |
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