The Study Of Correlation Between Homocysteine,proton Magnetic Reasonance Spectroscopy And Cerebral Infarction

[Objective]The purpose of our research is first, to study the relation between Homocysteine and Proton magnetic reasonance spectroscopy,then the correlation between them and Cerebral infarction. Second,to detect all the index of 1H-MRS and Hcy in acute cerebral infarction patients, and concentrate on the relation between the changes of the index and the prognosis of the patience, so as to evaluate the application value of 1H-MRS and Hcy in cerebral infarction.[Methods]Thirty patients presenting within 3 days of the onset and diagnosed as the cerebral infarction by the brain MRI inspection, were studied. Each patient's Hcy level in the venous blood is assayed. According to the Hcy level, these patients were classified into four groups: the normal group(≤15umol/L), including 4 cases, the mildly increased group(15～20umol/L), including 8 cases, the moderately increased group(20～25umol/L), including 10 cases and the seriously increased group(≥25umol/L), including 8 cases. Meanwhile, we did the 1H-MRS analysis on the infarction area and the opposite normal brain tissue and mainly detected the chemical shift position and the level of NAA (2.0ppm) and Lac (1.32ppm). All the patients'NIHSS scores were determined when they were on admission or treated after three months, and these two scores were noted as NIHSS1,NIHSS2, respectively. At last, we did the correlation analysis to the value of Hcy,NIHSS1,NIHSS2 and 1H-MRS, and drew the conclusion.[Results](1)Changes of 1H-MRS in cerebral infarction: (1) in the infarction area, increased Lactic acid peak in varying degrees was detected in all the patients except two cases; in the mirror imaging normal area, the Lactic acid peak was seemed to mildly increase in only three cases, and the other 27 cases were not. (2) The NAA peak in the center of the infarct area showed deceases in varying degrees compared to the opposite mirror image area on the other 29 cases, except one case, and this resut was confirmed by compared t test with significance(P<0.01).2. Increased Hcy in varying degrees can be seen in 86.7% of the cerebral infarction patients and the higher the Hcy is, the lower the NAA level of 1H-MRS is. And the accumulated NAA level in the various groups was significant different.3.Correlative analysis of metabolism changes in infarct center and NIHSS score, NIHSS prognosis showed that :(1)the vary of Hcy in infarct center had positive correlation with NIHSS1,NIHSS2(r=0.880 P<0.01;r=0.924 P<0.01). (2) the vary of NAA in the infarct center has obvious negative correlation with NIHSS1 and NIHSS2(r=-0.842 P<0.01;r=-0.818 P<0.01).⑶the vary of Lac has positive correlation with NIHSS1,NIHSS2 (r=0.776 P<0.01;r=0.796 P<0.01).(4) the vary of NAA in the infarct center has obvious negative correlation with Hcy(r=-0.748 P<0.01).[Conclusions]The level of Hcy and NAA,Lac in 1H-MRS all could contribute to the judgement of severity and prognosis of the cerebral infarction patients and there is significant correlation between them.