The Correlation Study Of Homocysteine,High-sensitivity C-reactive Protein With Recurrence Of Cerebral Infarction

Background: As a global health problem,stroke is one of the most deadly neurological diseases;it is the second leading cause of death for people over the age of 60,and the fifth cause of death for people fifteen to fifty nine.In China,Stroke has been the main cause of death,and brought enormous economic and mental stress to patients and families.Ischemic stroke(IS)has the highest proportion of stroke incidence and IS is the leading cause of death from stroke.China is one of the countries with a high exposure to stroke risk factors in the world,and about 94% of the stroke burden is caused by controllable risk factors.Therefore,secondary prevention of IS is very important.Stroke is currently considered to be caused by hypertension,diabetes,abnormal lipid metabolism,poor living habits such as smoking,drinking,diet,lack of physical activity,Hyperhomocy steinemia,overweight obesity and so on.Effective primary prevention and secondary prevention can effectively reduce the incidence of stroke,but some patients have frequent episodes of stroke despite very standardized treatment and prevention,which has caused huge trouble to patient's life and work.In recent years,some factors related to immune inflammation,such as cysteine(Hcy)and hypersensitive C-reactive protein(hs-CRP),have got more attention,their relationship with atherosclerosis and their prediction of the prognosis of cerebral infarction is currently inconclusive.This study examined the effects of hs-CRP and Hcy on the admission of patients with first-episode acute cerebral infarction on the short-term and long-term prognosis of first-episode acute cerebral infarction,and analyzed the relevant causes.It provides a new clinical direction for the diagnosis and treatment of acute ischemic stroke,and provides more scientific evidence for judging the prognosis and guiding prevention of acute ischemic stroke.Objective:Analyze the relationship between homocysteine?High-sensitivity Creactive protein levels and progression and recurrence of brain infarction.Provide new ideas and basis for reducing the progress and recurrence of cerebral infarction.To investigate the factors affecting serum hs-CRP and Hcy in acute phase of cerebral infarction and its relationship with short-term and long-term prognosis of cerebral infarction.For the treatment of cerebral infarction,to judge prognosis,primary prevention,secondary prevention provides new ideas.Methods: According Guidelines for the diagnosis and treatment of acute ischemic stroke in China(2014),diagnostic criteria for ischemic stroke.Take two hundred of first inpatient with acute cerebral infarction who be hospitalized in Henan University of Science and Technology First Affiliated Hospital between January to October in 2017 as the total sample.All the patients had been followed for a year.In two hundred patients,two of them had been dead,two of them were lost of contact,and finally we got one hundred and ninety six patients for research.Patients could be divided into two groups according to whether their illness have been worsen?relapsed.Scored neurological deficits in selected patients according to the National Institutes of Health Neurological Deficit Score(NIHSS),and collects other causes that may affect clinical short-term and long-term outcomes.Record the base information of every patients(include sex,age,smoking,drinking),clinical information(include hypertension,type II diabetes,coronary heart disease),test result(include HCRP,fasting blood sugar,uric acid,low density lipoprotein cholesterol,homocysteine etc).Analysis of the related factors affecting the recent condition of patients with firstepisode cerebral infarction and the recurrence of long-term cerebral infarction and whether the disease progresses after recurrence.Use Chi-square test,t test,and pearson correlation analysis to compare the differences between laboratory test indicators and NHISS scores between groups,Compare correlations between indicators,The inspection level is bilateral P<0.05,To determine the long-term and short-term predictive value of serum Hcy and hs-CRP in patients with first ischemic stroke,to provide a basis for the treatment and prevention of cerebral infarction.Result:1.Serum Hcy levels were positively correlated with NHISS scores.Serum hs-CRP levels were positively correlated with NHISS scores.2.Comparison between recurrent and non-recurrent groups,there were significant differences in serum Hcy ? UA ? LDL ? CRE ? hs-CRP ? diabetes hypertention between the two groups(P<0.05).3.Substitute factors affecting recurrence into multivariate analysis,it is concluded that Hcy,hs-CRP,hypertension and diabetes are independent risk factors for the recurrence of initial cerebral infarction.4.In the relapse group,there were significant differences in serum homocysteine ?UA?LDL?high-sensitivity C-reactive protein levels between the two groups in the relapse group and the non-progress group(P<0.05).5.Serum Hcy and hs-CRP levels can predict short-term and long-term outcomes in patients with first-episode cerebral infarction.Conclusion: Serum homocysteine and high-sensitivity C-reactive protein levels can predict the short-term and long-term outcomes of first-episode cerebral infarction,which can provide a basis for clinical prognosis.