Relationship Between Prognosis Of Homocysteine And Homocysteine In Patients With Acute Ischemic Stroke After Thrombolytic Therapy

Objective:To analyze the relationship between plasma homocysteine and prognosis of patients with acute ischemic stroke treated with intravenous thrombolytic therapy.Methods:The patients who were diagnosed as acute ischemic stroke from January 2015 to February 2017 at 4.5 h after onset and received intravenous thrombolytic therapy with atropase,were found to be high in homocysteine>15 umol//L and normal for homocysteine ? 15 umol//L on admission.Collect basic data such as gender,age,past medical history(hypertension,abnormal glucose metabolism,dyslipidemia,coronary heart disease,cerebral hemorrhage,stroke/transient ischemic attack),Atrial fibrillation,individual history(such as smoking,alcohol consumption,modified Rankin scale scale before onset,time from onset to thrombolytic therapy,plasma homocysteine D-dimer,etc.),admission NIHSS score and National Institutes of Health Stroke scale.Three months mRS score was used to evaluate the outcome,and 3 months mRS<2 was divided into good prognosis group and 3 month mRS ? 2 group as poor prognosis group.Logistic regression model was used to analyze the related factors of 3 months poor outcome of stroke patients.Result:This study included 300 patients with acute ischemic stroke,including 175 patients with good prognosis(L.e.,mRS<2 score)and 125patients with poor prognosis(mRS ? 2).The age,time from onset to thrombolysis in 3 months group and poor prognosis group were measured.There were significant differences in NIHSS score,blood pressure,blood lipid,history of atrial fibrillation,plasma homocysteine concentration and smoking history(P<0.05).Multivariate Logistic regression analysis,time from onset to thrombolysis,admission NIHSS score,hypertension and plasma homocysteine concentration were risk factors for clinical prognosis of stroke patients(P<0.05).Conclusion:The results of this case-control study showed that plasma homocysteine levels in patients with acute ischemic stroke were significantly higher than those in control group after intravenous thrombolytic therapy with rt-PA.Therefore,the prognosis of patients with acute ischemic stroke after thrombolytic therapy is closely related to plasma homocysteine content.