| Stroke, the common and multiple disease in nervous system, is one of the worst harmful diseases, which is high in the rate of morbidity, recurrence, fatality, and disability. 70% of stroke is occupied by the ischemic cerebral disease. It is predicted that ischemic cerebral disease will become the main cause of disability in the developing country in 2020. Because there is no ideal therapeutic method to the ischemic cerebral disease, it is important to explore there risk factors and restrain them in order to descend the morbidity and improve the prognosis. Homocysteine (Hcy), the high active sulf-amino acid, is the product of enzymatic hydrolysis response when Methionine is methylated into S-adenosyl methionine. It has been proven that the increasing blood concentration of Hcy is an important independent risk factor which causes the vascular disease in ordinary people (including cerebral, heart and peripheral blood vessels),It is believed that there is a notable relationship between hyperhomocysteinemia (Hhcy) and cerebral disease. Middle concentration of Hcy has the highest correlation with ischemic cerebral disease. But there is also controversy, the retrospective studies on cases have proved that there is a significant correlation between Hcy and arterial or venous thrombus, however some prospective studies have shown that there is less or no relationship between Hcy and cerebral diseases and Hcy is only probably the accompany factor and the indication of tissue damage in the cardiovascular and cerebral vascular diseases. Besides, there is few research about the relationship between the concentration of Hcy and the degree of nervous system functional impairment, and the results also have great divergences. In order to explore the relationship between the plasm concentration of Hcy and ischemic cerebral diseases and the degree of nervous system functional impairment; to offer proof for the prevention and cure of ischemic cerebral diseases, Plasm concentration of Hcy was been detected form different kinds of ischemic cerebral diseases patients. The object of this investigation were 87 admission patients in nervous department from 2004.3 to 2005.3, Sixty-seven cases with ischemic cerebral disease (including 45 with cerebral infarction and 22 with TIA) were selected and twenty cases without ischemic cerebral disease were acted as controls. These detects were done in all observers: Blood routine by label resistance , blood sugar by glucose oxidase method,blood lipids by enzyme, liver and renal function by terminal chromometry, plasm concentration of Hcy was detected by enzyme-linked immunosorbant assay. such as smoking, drinking, hypertension, diabetes and hyperlipemia, were also recorded. The hospital National Institutes of Health Stroke Scale (NIHSS) was used to make score about the degree of nervous system functional impairment of cerebral infarction, Correlation between the plasm concentration of Hcy and ischemic cerebral diseases was analysed. It is proved that drinking, hypertension, diabetes and hyperlipemia in ischemic cerebral disease group were all higher than controlled group; Plasm concentration of Hcy in the ischemic cerebral disease group ,cerebral infarction group, TIA group were all significant higher than the controlled group . However, there was no significant difference in the plasm concentration of Hcy between cerebral infarction group and TIA group. the plasm concentration of Hcy in male was significant higher than that in female in ischemic cerebral disease group. There was no significant rank correlative relation in cerebral group between plasma Hcy and NIHSS. It is proved from traditional risk factor analysis that there was no notable difference in the plasm concentration of Hcy between risk group and non-risk group; there was significant difference between the single hypertension group and Hhcy accompanied with hypertension in the possibility to suffer from ischemic cerebral disease. Mutivariable logisticregression showed plasma Hcy was independent risk factor of cerebral infarction. The results of the study about relation between the plasm concentration of Hcy and traditional risk factors are different at present. Many of study proved that the raising of plasm concentration of Hcy is an important risk factor of atherosclerosis , however, some believe that Hhcy isn't an independent risk factor of cardiovascular and cerebrovascular disease, but an accompany factor. Some study proved that the plasm concentration of Hcy had significant correlation with smoking, total cholesterol, blood pressure (systolic pressure especially), however, a multi-center case-control study making in Europe displaied that the raising of plasm concentration of Hcy had no correlative relation with traditional risk factors, but it can increase the risk of vascular disease. Moreover some suggested that the raising of plasm concentration of Hcy was an independent risk fator of atherosclerotic cardiovascular and cerebrovascular disease, it can strengthen the role of these tradition risk factor which can cause atherosclerosis such as hypertension, smoking and hyperlipemia. Through analyzing the relation between plasm concentration of Hcy and tradition risk factor, This text cued that plasm concentration of Hcy had no correlative relation with traditional risk factors, it was an independent risk fator. The plasma Hcy maybe cooperated with some traditional risk factors to accelerate the occurrence of ischemic cerebral disease.These was a notable relationship between the high plasma Hcy level and vascular disease, mechanism maybe : Hhcy had toxic effect to vascular endothelial cell; Hhcy could affect blood coagulatlon mechanism; Hhcy could affect apoptosis and DNA injury ; Hhcy could affect cellular gene; and so on. As stated above, through exploring the relationship between the plasm concentration of Hcy and ischemic cerebral diseases and the degree of nervous system functional impairment ,we could made this conclusion : the patients with ischemic cerebral diseases (including cerebral infarction and TIA) had... |
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