The Effect Of Berberine Hydrochloride On The Levels Of Serum Homocysteine In Patients With Acute Cerebral Infarction

Objective:We measured the level changes of serum homocysteine (Hcy) inpatients with acute cerebral infarction (ACI) to investigate the relationship between theseverity of the disease, serum lipid, fasting blood glucose (FBG) and serum C-reactiveprotein （CRP）of ACI and the levels of Hcy. And then the patients were divided intotwo groups, one took berberine hydrochloride (BBR) as one of therapeutic drugs andthe other not. So we could further investigate whether BBR could reduce theconcentration of Hcy, and then discussed the pathophysiologic mechanism of berberine.Method: We selected44healthy patients as control group and52patients withACI as cerebral infarction (CI) group. The CI group then was further randomly dividedinto two groups, one was as standard group patients, the other was berberine group(patients took BBR). The former included31cases, and the latter included21cases. Allthe patients satisfied the inclusion criteria and exclusion criteria. The control group andthe CI group were comparable on gender and age propoption (P>0.05). So were thestandard group and the berberine group. The levels of Hcy,serum lipid, fasting bloodglucose (FBG) and C-reactive protein were measured by the Enzymatic cycling assay,turbidimetry and the Rate nephelometry respectively. Meanwhile, we observed thelevels of those indicators within48hours of onset and the levels of Hcy of the10th dayafter the admission. At the same time, refer to the references, the CI group was alsodivided into hyperhomocysteinemia group and non-hyperhomocysteinemia groupaccording to the levels of serum Hcy of48hours of onset.The loss of neurologicalfunction was measured twice on baseline and the10th day by the specializedneurologist according with NIHSS scale. All the results on baseline were marked as “1”and those on the10th day were marked as “2”, and (1subtract2) was marked asD-value. All the datum were analyzed by SPSS11.5statistics software. Thesignificance level for bilateral test was less than0.05(P＜0.05). Results:1、The level of Hcy1of the CI group was significantly higher than that of thecontrol group（P＜0.01）. The serum Hcy level of Hcy2were higher than that of thecontrol group,but the difference was not significant.2、The analysis of multivariate stepwise Logistic regression showed that high Hcywas the independent relevant factor of CI （OR=5.240, P=0.001）. The level of NIHSSscores of the hyperhomocysteinemia group was signifycantly higher than that of thegroup without hyperhomocystein-emia (P<0.01).3、The level of Hcy1of the CI group had significantly positive relationship withthe levels of CRP(r=0.364, P<0.01),but have no obvious correlation to FBG and serumlipid.4、The levels of Hcy1of the BBR group had no significant difference compared tothe standard group. The levels of Hcy2of the BBR group were significantly lower thanHcy1（P＜0.01）. The serum Hcy D-value of the BBR group were significantly higherthan the standard group （P＜0.05）. The levels of Hcy2of the standard group werelower than Hcy1with no significant difference.Conclusions:1、The level of Hcy of48hours of onset increased significantly in the acute phsesof CI. It suggested that Hcy might involved in the pathophysiological process of acutecerebral infarction.2、The level of Hcy was correlated to the severity of the disease. The patients withhigher level of Hcy had higher NIHSS scores.3、 The Hcy level on baseline of the CI group had significantly positiverelationship with the levels of CRP,but have no obvious correlation to FBG and serumlipid.4、BBR could reduce the level of serum Hcy significantly during the acute phaseof CI. It suggested that berberine hydrochloride may be beneficial for improving theprognosis of acute cerebral infarction.