The Differences Of Hyperhomocysteinemia Between The Young Patients With Cerebral Infarction In Different TOAST Subtypes

Objective: In china, cerebral infarction has become the leadingcause of death. Hypertension, diabetes, smoking, alcohol consumption areconsidered as the clear risk factors, treatment for these risk factors canreduce endpoint (cerebral infarction) occurrences. With the progress ofthe study, more and more experiments prove that homocysteine has beenan independent risk factor of cerebral infarction, especially in youngpatients. Although its pathogenic mechanism is not very clear, these studyhas found that homocysteine can promote the formation of atherosclerosis,then cerebral infarction occurrences. Beside that, homocysteine also playsan important role in the recurrence and disability of cerebral infarction.At present, cerebral infarction patient can divided into5typesthrough the imaging examination and analysis of risk factors, this is callsTOAST types. It is useful for the early evaluation of the prognosis, todetermine the patients who has high risk of severe neurologic impairment,to predict the early recurrence and complications, to judgment whetherneed long-term care after discharge or not, to predict the morbidity andmortality. It is also useful in formulating prevention of cerebral infarction,and in efficacy study and epidemiological studies.This study selected young patients with cerebral infarction, andtyped into5groups, then measured the level of homocysteine, finallycompared the differences of the homocysteine among these groups. Comparing the different abnormal rate to study the risk in every group.Method: Selecting the patients in our hospital whose age is less than45years old and with cerebral infarction confirmed by head CT or MRIexamination. A total of72cases, including55cases of male patients,17cases of female patients. Determination of the levels of Hcy byfluorescence and biochemical analysis, all subjects admitted2ml bloodinto EDTA anticoagulant tube, then centrifuged within4hours, removeplasma immediately to detect Hcy, at the same time, biochemistry andimmunology examination are conducted.Result: Large artery atherosclerosis group has25cases,9cases arehigher. Cardiogenic embolism group consists of5cases, all of these arenomal. Small artery occlusion group contains24cases, which2cases arehigher than normal. The other causes group consists27cases, which9cases are abnormal. Unexplained group incledea8cases, which4caseswere higher than normal. Analysis found that patients in arteryatherosclerosis group and unexplained group have an average of higherthan normal value. X2test found that elevated levels in unexplained grouppatients has statistical significance(P＜0.05).Conclusion: High homocysteine has the role in promotingatherosclerosis, especially in the patients whose reason for the cerebral infarction is not clear, homocysteine abnormal can be a risk factor ofcerebral infarction is more significant.