目的 探讨血清同型半胱氨酸（Hcy）在烟雾病患者中检测的临床价值及与烟雾病发病机制中的相关性。 方法 分析250例烟雾病患者的年龄分布及临床症状，对确诊烟雾病患者行外科手术治疗，收集烟雾病患者血清样本术前250份，术后250份，所有患者根据MRA影像结果分为6期，I、II、III期为烟雾病发展早期，IV、V、VI期为烟雾病发展晚期，正常对照组250例，测定所有入组患者和正常对照人群的血清同型半胱氨酸水平，用统计学方法比较分析。结果 烟雾病患者250例中，缺血型201例，占80.40%（201/250）；出血型45例，占18.00%（45/250）；混合型4例，占1.60%（4/250）。烟雾病术前组与正常对照组比较，P<0.001烟雾病术后组与正常对照组比较，P<0.001，差异均有统计学意义（P<0.001）。烟雾病患者术前组和术后组Hcy水平无明显变化，差异无统计学意义（P=0.95）。术前高Hcy血症患者89例，占35.60%。其中32例以出血为首发症状的病例均无再出血，166例以缺血为首发症状的病例中145例治疗后症状明显缓解，21例无明显变化。术后高HCY血症患者87例，占34.80%。结论 本研究提示血清Hcy可能参与了烟雾病血管损伤的发病过程，对烟雾病患者常规监测Hcy水平并与影像学技术结合，可作为烟雾病高危患者临床筛查指标。

Abstract: Objective To investigate the clinical significance of serum homocysteine in patients with moyamoya disease. Methods 250 cases of serum samples of patients with moyamoya disease were collected from the department of neurosurgery. According to the MRA images the patients were divided into 6 phase groups, phase I, II and III were early stage in the development of moyamoya disease. Phase IV, V and VI were late stage in the development of moyamoya disease. The serum homocysteine levels in patients and 250 cases of normal control were detected. Results The serum homocysteine levels in patients with moyamoya disease were significantly higher than that of in normal controls (P<0.001). There were no significantly difference between late stage phase group with early stage group patients with moyamoya disease (P>0.05). Conclusion The serum homocysteine may play a role in blood vessel damage of moyamoya disease.