Research On The Correlation Between HCY/RDW And Acute Ischemic Stroke And Carotid Atherosclerosis Plaque

Objective: To verify whether HCY and RDW are risk factors for cerebral infarction and explore the correlation between HCY and RDW and the severity of cerebral infarction,we studied the role of HCY and RDW in the development and formation of acute ischemic stroke and carotid atherosclerosis plaque.This study focused on the effects of HCY and RDW on the formation and stability of carotid atherosclerosis plaques in patients with cerebral infarction,and hoped to provide evidence for the secondary prevention of ischemic stroke.Methods: Select 122 cases of patients with ischemic stroke in the First Affiliated Hospital of Wannan Medical College from April 2015 to December 2016,who were diagnosed with acute ischemic stroke by brain CT and/or MRI as the cerebral infarction group.89 cases of patients with non-cerebrovascular disease as the control group in the same period.The clinical datum of patients was collected,including NIHSS score,general history,medical history,HCY,RDW and other related laboratory indexes.All patients underwent carotid ultrasonography examination within 3 days after admission.patients in the cerebral infarction group were divided into the no plaque group and the plaque group,the latter further divided into the vulnerable plaque group and the stable plaque group,according to the results of carotid ultrasonography examination,IMT values were measured and recorded.HCY,RDW and the other clinical data were compared between the cerebral infarction and the control group,as well as the groups in the cerebral infarction group.All data were analyzed by SPSS 18.0 software,the measurement datum was in normal distribution,which was expressed as sx ±,and t test was used for comparison between groups;the enumeration datum was expressed as a count(percentage),and chi-square test was used for comparison between groups;Linear correlation analysis was used to analyze the correlation between the two variables.Multi-factors binary Logistic regression analysis was used to screen the significant factors that influence the formation and stability of cerebral infarction.Results: 1.The detection rate of plaques?vulnerable plaques and multiple plaques of carotid artery in the cerebral infarction group was significantly higher than those in the control group;2.HCY,RDW,GLU,LDL,history of hypertension and diabetes mellitus in the cerebral infarction group were significantly higher than those in the control group(P < 0.01);TG?Fib and smoking history in the cerebral infarction group were higher than those in the control group(P < 0.05).The conclusion that HCY,RDW,LDL and diabetes were independent risk factors for cerebral infarction is drawn by Logistic regression analysis;3.HCY,RDW,LDL,age,history of hypertension and diabetes mellitus in the plaque group were higher than those in the no plaque group(P < 0.05),no difference of the other indexes between the two groups;HCY,RDW,TG,LDLand history of hypertension in the vulnerable plaque group were significantly higher than those in the stable plaque group(P < 0.01);Age and Cys-C in the vulnerable plaque group were also higher than those in stable plaque group(P < 0.05);The conclusion that HCY,RDW,LDL were risk factors for plaque stability is drawn by Logistic regression analysis;4.The conclusion that there were significant differences in HCY and RDW among thethree groups of cerebral infarction(P <0.01),and RDW and HCY in the vulnerable plaques group were higher than those in the no Plaque group and stable Plaque group(P < 0.01);5.There was a positive correlation between the HCY/RDW and the carotid artery IMT value(correlation coefficient was 0.56,0.52 respectively,P <0.01);6.There was a positive correlation between the RDW and the NIHSS score(r=0.614,P < 0.01);HCY has no correlation with RDW(r=0.1,P > 0.05);Conclusions: 1.Carotid plaques,especially vulnerable plaques and multiple plaques are risk factors for ischemic stroke;2.HCY and RDW were independently correlated with acute cerebral infarction;3.RDW can reflect the degree of neurological impairment in patients with cerebral infarction;4.HCY and RDW are involved in the development of carotid plaques,which are the risk factors for carotid plaque stability.