目的：探讨血同型半胱氨酸（Hcy）水平与急性脑梗死（ACI）合并缺血性脑白质病变（WMIL）在不同病 因下的相关性。方法：选择 ACI、WMIL 患者 280 例，分为单纯动脉粥样硬化血栓型脑梗死（AT）组、单纯 WMIL组、（AT+WMIL）组及（小动脉闭塞卒中+WMIL）（SAO+WMIL）组各70例，测定其血Hcy水平，组间 互相比较。结果：（AT+WMIL）组、（SAO+WMIL）组的Hcy水平高于单纯WMIL组（P＜0.05，P＜0.01）。Logistic 回归分析结果显示年龄、TG 对 ACI 合并 WMIL 患者的影响具有统计学意义（P＜0.05），同时 Hcy 对 ACI合并WMIL患者的影响更具统计学意义（P＜0.01）。结论：Hcy水平升高与ACI合并WMIL的发生密切 相关，但其与病因无相关性

To discuss the correlation between homocysteine (Hcy) level and acute cerebral infarction (ACI) combining with white matter ischemic lesion (WMIL) under different disease causes. Methods: A total of 280 patients with ACI combined with WMIL verified by CT and MRI were recruited to this study. Patients were divided into the atherosclerosis thrombotic cerebral infarction only group (AT group), WMIL only group (WMIL group), (AT+WMIL) group, and (SAO+WMIL) group, with 70 patients per group. The level of Hcy was measured for comparisons among groups. Results: The Hcy level of the (AT+WMIL) group and (SAO +WMIL) group was higher than that of the WMIL group (P<0.05, P<0.05). Logistic regression analysis indicated that age and TG are statistically significant factors in ACI patients with WMIL (P<0.05); meanwhile, Hcy showed more statistical significance in these patients (P<0.01). Conclusion: Elevated Hcy level is closely related to ACI with WMIL, but it has no correlation with the etiology of ACI with WMIL.