The Relationship Between Homocysteine And Severity, Risk Factors Of Acute Ischemic Stroke

Objective:The relationship between homocysteine and ischemic stroke is still controversial. We investigate the relation between homocysteine and risk factors of acute ischemic stroke. We further focus on the relationship between homocysteine and type, severity, and prognosis of ischemic stroke.Methods:We enrolled 160 acute cerebral infarction patients identified by brain MR/CT between February 2009 to December 2009. we obtained the compeletely history of all patients, evaluate the NIHSS score and the BI index. We determinated the homocysteine, folate, vitamin B12, creatinine, hs-CRP, and blood lipids, blood coagulation within 7 days of onset. Correlation analysis was used to determine the relationship between homocysteine and folate,vitaminB 12,creatinine,.hs-CRP, blood lipids, carotid IMT, fibrinogen repectively. The LAA group according to the level of Hcy were divided into 3 groups:Hcy increased slightly, moderately elevated, the normal range group. We compared the NIHSS score and the BI index in onset, and compared difference of NIHSS score in the acute stage and 3 months among the groups. Group of cases were further stratified in accordance with Hcy and IMT, LDL, HDL respectively in the LAA groups, compared difference of NIHSS score between the acute stage and 3 months among the groups to assess each group of neurological functional impairment of recovery.Results:Hcy was negatively correlated with vitamin B12, folic acid, and positively correlated with creatinine. Hcy and carotid artery IMT is positively correlated; Hcy was negatively correlated with HDL Patients in LAA group was grouped according to the level of Hcy, the incidence of initial NIHSS score and the BI index among the groups are no significant difference. The difference of each group between the NIHSS score onset and NIHSS score at 3 months are no significant difference; The LAA group patients were stratified in accordance with the Hcy and IMT, LDL, HDL respectively,and the differences of each group between the NIHSS score of acute stage and NIHSS score at 3 months are no significant difference. Patients with high Hcy and high LDL, as well as patients with high Hcy and low HDL exhibit poor prognosis compared with other patients.Conclusion:In patients with acute ischemic stroke, level of Hcy was correlated with folate,vitaminB12 and creatinine; Hcy is positively correlated with carotid artery IMT, was negatively correlated with HDL. Other factors such as hs-CRP, LDL, fibrinogen showed no significant correlation. In our research, levels of Hcy and the severity of acute ischemic stroke and prognosis of 3 months exhibit no significant correlation. HHcy with high LDL,and HHcy with low HDL exacerbate the prognosis of LAA.