Study On Relationship Between Hyperhomocysteinemia And Cerebral Infarction And The Number Of Artery Stenoses

Research Objective In the recent years,more and more researches on animals,clinic and epidemiology both at home and abroad show that hyperhomocysteinemia(HHcy) is a new independent dangerous factor resulting in cerebral infarction,cervical and cerebral stenosed artery triggered by atherosclerosis is the foremost cause of cerebral infarction.The past researches both at home and abroad were mostly focused on relationship between the level of homocysteine(Hcy) and stenosed degree of cervical and cerebral artery,while few reports were involved in relationship between the level of Hcy and the number of stenosed cervical and cerebral artery.This research aims to study on relations concerning the level of Hcy and attack of cerebral infarction,and number of stenosed artery,as well as other dangerous factors causing cerebral infarciton.Research Method Select 80 patients suffering from cerebral infarction hospitalized in Shandong trafic hospital from January,2006 to December,2007,including 50 male cases and 30 female ones with average age of 60.50±9.97,who are all in line with the diagnostic standards revised in the 4th session of national conference on cerebrovascular disease in 1995, and confirmed by cranial CT and cranial MRI;of which 59 cases of hypertension,43 cases of hyperlipidemin,12 cases of diabetes and 31 cases of smokers with over 6-month smoking. Another 50 recipients of health checkup are selected as control,including 34 male cases and 16 female ones with average age of 60.71±7.52 and without the medical history of clinical cerebrovascular disease;of which 26 cases of hypertension,21 cases of hyperlipidemin,8 cases of diabetes and 12 cases of smokers with over 6-month smoking.There is no statistics difference(P＞0.05 ) in the two groups on structure of age and gender.The two groups are both excluded from thyroid dysfunctions,visible liver and renal function damage,atrial fibrillation,cancer and psoriasis,and have no taking of vitamin B and of medicine affecting vitamin metabolism within 2 weeks.The group of 80 cerebral infarction patients has received the check of cervical and cerebral magnetic resonance angiography(MRA) after hospitalization,the adopted machine is Magnetom 63SP from Siemens,field intensity is 1.5T superconducting magnetizer,and "time-of-flight(TOF)" is adopted for angiography.It is found 32 cases have 2 or more numbers of stenosed arteries,set as Group A;and 48 cases have no or 1 number of stenosed artery,set as Group B.4ml venous blood is taken from the 2 groups with empty stomach in the early morning,and put into EDTA anticoagulant tube.By centrifugal effect(5000r/min,10min) under 4℃within 15 minutes,plasm is separated and saved at -70℃for check.Special mated reagents manufactured by BEIJING biology technology company are used and analytical method of ELISA is adopted for testing;the concentration of HCY＞15umol/L,which is diagnosed as HHcy.2ml venous blood is taken from the groups with empty stomach in the early morning,with blood serum separated and preserved at -70℃for check.We use radioimmunoassay to test flate and VitB₁₂.The test of other biochemical indexes:venous blood is taken from the groups with empty stomach in the early morning,and auto biochemical analysis apparatus is utilized to measure lipemia,blood sugar,liver and renal function,and monitor blood pressure.All variables are represented as ((?)±S),the comparison between two averages is tested by non-mated t,OR value is calculated by enumeration data and tested by x²,the significant difference is proved if P＜0.05.Result1.Comparison of Hcy,folate and vitamin B₁₂:36 patients suffer from HHcy of the 80 cases of cerebral infarction,accounting for 45%.The average plasm Hcy level of the cerebral infarction group is higher than that of the control with the significant difference(t=13.577,P＜0.05);the level of average serum folate(t=9.558,P＜0.05) and the level of vitB₁₂(t'=-8.451, P＜0.05) are both lower than the level of the control,with significant difference.In the group of cerebral infarction,the average plasm Hcy level of Group A is higher than that of Group B, with significant difference(t=2.451,P＜0.05),the level of folate of Group A is lower than that of Group B,with significant difference(t=2.283,P＜0.05),the level of vitamin B₁₂ of Group A is lower than that of Group B,while without any statistic meaning(P＞0.05). 2.Relationship between plasm Hcy level and other dangerous factors resulting in cerebral infarction:in the 80 cases of cerebral infarction,coalescent HHcy patients come to 36 cases,set as HHcy Group,embracing 27 cases of hypertension,20 cases of hyperlipidemin,5 cases of diabetes and 13 cases of smokers with over 6-month smoking;normal Hcy patients amount to 44 cases,set as normal Hcy Group,including 32 cases of hypertension,23 cases of hyperlipidemin,7 cases of diabetes and 18 cases of smokers with over 6-month smoking.By statistic analysis,the plasm Hcy level has no obvious relativity with the dangerous factors arousing cerebral infarction such as hypertension,hyperlipidemin,diabetes,record of smoking,etc,P＞0.05 by the test of X² without exception.3.Comparison between HHcy and other dangerous factors causing cerebral infarction: the group of cerebral infarction includes 36 cases of coalescent HHcy,59 cases of hypertension,43 cases of hyperlipidemin,12 cases of diabetes and 31 cases of smokers with over 6-month smoking;the control includes 8 cases of coalescent HHcy,26 cases of hypertension,21 cases of hyperlipidemin,8 cases of diabetes and 12 cases of smokers with over 6-month smoking.By calculation it is found that OR value of HHcy(OR=7.18) is obviously higher than that of hypertension(OR=3.10),hyperlipidemin(OR=2.51),diabetes (OR=2.01) and record of smoking(OR=2.45),therefore HHcy is of more danger compared with other dangerous factors resulting in cerebral infarction;hypertension, hyperlipidemin,diabetes and record of smoking.Conclusion1.HHcy is a cardinal and independent dangerous factor causing cerebral infarction, whose fatalness is higher than that of other dangerous factors triggering cerebrovascular diseases;hypertension,hyperlipidemin,diabetes and record of smoking.2.The plasm Hcy level has no obvious relativity with the dangerous factors resulting in cerebral infarction such as hypertension,hyperlipidemin,diabetes,record of smoking,etc.3.The increase of the plasm Hcy level is closely related with the attack of cerebral infarction and the number of stenosed cervical and cerebral artery.The higher the plasm Hcy level goes,the higher incidence of cerebral infarction amounts to.The plasm Hcy level shows a significant positive relativity with the number of stenosed cervical and cerebral artery.