| Objective: To study the relationship between hyperhomocysteinemia (Hhcy) and acute cerebral infarction (CI) and the Hhcy's influence on the recent prognosis of CI. At the same time, we will also analyse methlenetetrahydrofolate reductase (MTHFR) gene C677T polymorphisms of the subjects, which can lead to Hhcy. Methods: We studied 121 patients with CI (acted as patient group) and 52 normal people whose ages and gender were matched with patient group (acted as control group) . Fast plasma total homocysteine (tHcy) levels were detected by high-performance liquid chromatography (HPLC); MTHFR gene C677T polymorphisms were analyzed by PCR-RFLP technology;TC, TG, fast blood sugar, et al were also examined. We devided the patient group into Hhcy group and No Hhcy (NHhcy) group on the basis of the examining result of control group's tHcy. We evaluated the patients' neural function within 3 days after stroke onset according to National Institutes of Health Stroke Scale (NIHSS). Then we prospectively observed the patients' neural function and ability of daily life according to NIHSS and Barthel Index (BI) on the 7th 14th. 30th, 90th, 180th day after stroke onset. Result: (1)The levels of plasma fast tHcy in male and femal patients were 24.39+ 10.60umol/L and 17.38+6.87 umol/L respectively, both significantly higher than those in the corresponding control group ( male 14.69?.92? mol/L, female 11.47 ?.47 u mol/L ) , both P<0.0l.(2)There were three kinds of genotypes in MTHFRgene C677T polymorphisms : homozygous mutation (T/T) , heterozygous mutation (T/C) and wild type (C/C). The frequencies of the three genotypes in patient group were as follows: T/T , 35.54% ; T/C , 48.76% ; C/C , 15.7% , significantly different from those of control group (PO.05); the frequency of T allele hi patient group was 59.92% , significantly higher than that of normal individuals which was only 35.58% (P<0.01).(DThe same tendency of plasma tHcy levels in three genotypes exists in the patient and control group, fast plasma they level in T/T genotype were higher than that in T/C and C/C genotype (P<0.05), there were no significant difference between the T/C and C/C genotype (P>0.05).(5)Spearman analysis confirmed that there was not significant correlation of tHcy with TC, TG, et al except gender. Within 3 days and on the 7th , 14th day after stroke onset, the difference of the NIHSS and BI scale of Hhcy and NHhcy group were not significant (P>0.05). On the 30th, 90th and 180th day, the NIHSS and the BI of Hhcy group respectively was 11.94 ?7.98, 10.27 ?.19, 8.45?.47 and 65.94?6.56, 74.44?4.18, 82.12?2.69, significantly different from those of the NHhcy group whose was 8.72 ?.08, 6.96?.42, 5.17+ 4.45 and 75.60?2.92, 83.49?19.12, 91.63?4.50 respectively (P<0.05) . Conclusions: Hhcy was not only an important risk factor for CI but also harmful to the recent rehibilitation of patients with CI.(2)MTHFR gene C677T mutation was probably important genetic factors which lead to CI by elevating the tHcy levels.
|
PDF Full Text Request