The Relationship Between Serum Homocysteine Levels In Stroke Patients And The Short-term Prognosis

Objective：Stroke is one of the important diseases that threat the population health.Stroke ranks the second leading cause of death and first leading cause of disabilityworldwide. It is characterized with high morbidity, mortality, relapse rate and disabilityrate. Shortly after the onset of paralysis in stroke patients recovery key, directly affectlong-term prognosis. Study of main influence factors of short-term prognosis in patientswith stroke, and to take appropriate preventive measures, is especially important topatients ’ degree of paralysis.This study draws on prognosis of patients with stroke in retrospective cohort. Toexplore the effect of baseline serum Homocysteine level and traditional risk factors onischemic stroke patients prognosis during hospitalizationSubjects and Methods：First people’s Hospital of Kunshan city, February toOctober2013~2014years of386cases of stroke patients admitted to Neurology study.We collected demographic information, lifestyle, clinical characteristics, laboratory testsand disease history. Serum Homocysteine concentrations were tested by automaticchemiluminescent analyzer MODULAR_DP within24hours after the admission. Weevaluated patients during hospitalization by the modified Rankin Scale and NationalInstitute of Health stroke scale. Death and major disability (MRs≥3)were defined as theoutcome of this study. Multivariable logistic model was used to analyze the associationbetween serum Homocysteine level and traditional risk factors with outcome duringhospitalization and OR(95%CI) was calculated. We also made a linear trend testbetween serum Homocysteine level, traditional risk factors and outcome in logisticmodel. Finally, we made a subgroup analyze serum Homocysteine level and compositeoutcome in different stratums.Results：In hospitalization, compared with the patients younger than65years, the OR(95%CI) of adverse outcome among patients older than65years was4.65(1.90-11.34). Compared with blood glucose＜7.0mmol/L patients, bloodglucose≥7.0mmol/L patients were at adverse outcome2.68(1.21，5.93). Compared withDiastolic blood pressure＜100mmHg patients, Diastolic blood pressure≥100mmHgpatients were at adverse outcome4.54(1.75-11.80). Compared with Hcy＜15μmol／Lpatients, the OR(95%CI) of adverse outcome among Hcy≥15μmol／L patients was1.05(0.50，2.20), A dose response relationship was age, blood glucose，Diastolic bloodpressure and adverse outcome in hospitalization (P<0.05). No dose responserelationship was detected between serum Hcy and adverse outcome in hospitalization(P>0.05).Conclusion：1. Age increasing, higher severity of admission,baseline high bloodglucose and diastolic blood pressure increase significantly14th or discharge in patientswith risk of adverse outcomes.2. A dose response exists among age,blood glucose,blood pressure and ischemic stroke prognosis.3. Hcy level is not associated withischemic stroke prognosis in hospitalization.