Clinical Study Of Cerebral Infarction And Serum Homocysteine

Objective: Study the relationship between serum homocysteine and cerebral infarction, to explore whether moderately elevated serum homocysteine concentration is an independent risk factor for stroke. Examine the difference of homocysteine among the subtypes of cerebral infarction. Reserch the relationship between homocysteine and other risk factors of stroke.Method: Fasting serum homocysteine was measured with cyclophorase method. Collected the patients with cerebral infarction (first onset or relapse patients ) treatment in our hospital from September 2006 to February 2007 as the case group, the same period patients of other diseases and physical examination people as the control group. We conducted a case-control study.Results: Mean serum homocysteine of cerebral infarction (15.24±7.47μmol/L) was significantly higher than control subjects (12.18±5.72μmol/L), P<0.05. If the diagnostic criteria for hyperhomocysteinemia is 20μmol/L, the incidence of cerebral infarction in patients was 21.6%, while the control group was 3.3%, there was a significant difference between the two (P<0.05) groups.The rate of hypertention in cerebral infarction group was significantly higher than control group(P<0.05),while gender, age, smoking history, fasting glucose, triglyceride, cholesterol, high-density lipoprotein, low-density lipoprotein, were non-significant difference.2. In patients with cerebral infarction, 84 patients aged over 65 years,mean homocysteine 15.30±6.04μmol/L, 55 patients aged lower 65 years,mean homocysteine 16.88±9.62μmol/L, the difference between the two groups was not significant (P> 0.05).3. In the various risk factors of cerebral infarction, the elevated serum homocysteine was related to systolic blood pressure (P <0.05),while age, diastolic blood pressure, blood glucose, triglyceride, cholesterol were unrelated.4. In the various risk factors of cerebral infarction, hypertension, diabetes, hyperlipidemia, and serum homocysteine were related to ischemic stroke, after controlling other risk factors, homocysteine was closely related to cerebral infarction (r = 0.43,P<0.01).5. In the TOAST subtype of cerebral infarction, Large-artery atherosclerosis 47 cases, mean homocysteine 16.10±7.05μmol/L, Cardioembolsm 7 cases, mean homocysteine 14.10±5.76μmol/L, Small-artery occlusion Lacunar 18 cases, mean homocysteine 16.14±11.56μmol/L, Acute stroke of other determined etiology 4 cases, mean homocysteine 17.90±4.07μmol/L, Stroke of other undermined etiology 18 cases, mean homocysteine 15.32±5.60μmol/L, compared with the control group, there were significant differences (P <0.05), no difference between the subtypes.6. In the patients with acute cerebral infarction, the first incidence 94 cases, mean HCY 14.37±4.11μmol/L, recurrence 45 cases, mean HCY 16.84±9.43μmol/L, the two groups was no statistical significance.Conclusions:1. Hyperhomocysteinemia is an independent risk factor for ischemic strokes.2. There is close correlation between hypertention and homocysteine.3. There is no association between homocysteine and TOAST subtype of cerebral infarction, no significant correlation between homocysteine and age,no difference between homocysteine and sexuality, no difference of homocysteine between first incidence and recurrence cerebral infarction.