| Objective: Acute ischemic stroke is one of the common diseases in Internal Medicine-Neurology featured with high incidence,high recurrence rate,high disability rate and high mortality rate.Controlling various high-risk factors is the key to prevent the occurence of ischemic stroke while atherosclerosis is attached special importance to as the target to prevent the occurence of ischemic stroke.Cys-C was firstly found from cerebrospinal fluid(CSF)in 1961 and participated in a number of pathological and physiological process in vivo as a member of cysteine protease inhibitor superfamily.As discovered by previous research,it can be used as the good indicator to reflect the early renal dysfunction because it can reflect the renal dysfunction at the early stage.In recent years,as discovered by more and more research,Cys-C can participate in the occurrence and development of atherosclerosis through breaking the dynamic balance produced and degraded by extracellular matrix of cell intima.HCY belongs to sulphur-based amino acids and does not participate in the synthesis process of protein as an important intermediate product during the methionine and cysteine metabolism process.There is research showing that,through various direct and indirect approaches,HCY can damage vascular endothelial cells,promote the reproduction of vascular smooth muscle cells,influence the metabolism and oxidation of tissue cells,promote local platelet aggregation and cause the formation of thrombus.Thus,Cys-C and HCY are both related to the occurrence and development of atherosclerosis.This research aims at discussing the relationship of serum Cys-C and HCY on intracranial vascular lesions of acute ischemic stroke.Method:112 cases of patients with acute ischemic stroke who were hospitalized at Internal Medicine-Neurology of The Second Hospital of Anhui Medical University from January 2017 to May 2017 are taken as the research objects(whose disease course is within 2 weeks).The age,gender,existence of risky factors for vascular diseases(e.g.hypertension,coronary heart disease,diabetes,hyperlipidemia,etc.),smoking history and drinking history of all the patients are recorded and biochemical instruments are used to detect the levels of TC,HDL,LDL,Cys-C and HCY of all the patients.Cranial MRA examination is conducted on all the patients who are grouped according to the degree of vascular stenosis and the number of vascular lesion.The differences among risky factors for each vascular lesions,Cys-C and HCY levels,different degrees of vascular stenosis and different number of vascular lesions are compared and Pearson correlation analysis is simultaneously applied to analyze the correlation between Cys-C,HCY and different degrees of vascular stenosis and different number of vascular lesions.Result:1.According to Cranial MRA,the degree of vascular stenosis is divided into the non-stenosis group,the slight-stenosis group,the intermediate-stenosis group and the severe-stenosis group or the blocked group.The number of male cases/proportions are: 24(68.6%),13(50.0%),13(68.4%),26(81.3%),respectively.The ages are: 60.51±11.10,66.88±11.15,69.26±9.93,63.16±14.56,respectively.The number of smoking cases/proportions are: 13(37.1%),7(26.9%),9(47.4%),16(50.0%),respectively.The number of drinking cases/proportions are: 10(28.6%),4(15.4%),10(52.6%),13(40.6%),respectively.The number of cases/proportions with history of hypertension are: 18(54.3%),22(84.6%),15(78.9%),18(56.3%),respectively.The number of cases/proportions with history of diabetes are: 6(17.1),15(57.7%),5(26.3%),3(9.4%),respectively.The serum TC values are: 4.48±1.02,4.92±1.17,4.66±1.39,4.24±0.84,respectively.The serum HDL values are: 1.26±0.33,1.18±0.25,1.23±0.30,1.24±0.36,respectively.The serum LDL values are: 2.76±0.75,3.14±0.83,3.02±1.07,2.66±0.63,respectively.The ages,the drinking history,the hypertension history,the diabetes history are different among the four groups and the differences are of statistical significance(P<0.05).2.According to Cranial MRA,the degree of vascular stenosis is divided into the non-lesion group,the 1-lesions group,the 2-lesion group and the multiple-lesion group.The number of male cases/proportions are: 23(69.7%),16(69.6%),7(53.9%),30(69.8%),respectively.The ages are: 60.12±11.27,65.17±15.03,63.46±10.81,67.12±11.39,respectively.The number of smoking cases/proportions are: 12(36.4%),12(52.2%),3(23.1%),18(41.9%),respectively.The number of drinking cases/proportions are: 9(27.3%),9(39.1%),1(7.7%),18(41.9%),respectively.The number of cases/proportions with history of hypertension are: 17(51.5%),12(52.2%),8(61.5%),36(83.7%),respectively.The number of cases/proportions with history of diabetes are: 6(18.2),3(13.0%),6(46.2%),14(32.6%),respectively.The serum TC values are: 4.46±1.07,4.33±0.82,4.80±1.29,4.65±1.22,respectively.The serum HDL values are: 1.26±0.34,1.19±0.30,1.27±0.29,1.21±0.32,respectively.The serum LDL values are: 2.73±0.76,2.74±0.62,3.01±0.89,2.99±0.92.The hypertension history is different among the four groups and the difference is of statistical significance(P<0.05).3.According to the degree of vascular stenosis,they are divided into the non-stenosis group,the slight-stenosis group,the intermediate-stenosis group and the severe-stenosis group or the blocked group.The serum Cys-C values are 0.61±0.19,0.76±0.19,0.86±0.19,0.88±0.23,respectively.The serum HYC values are 13.83±3.90,16.60±2.71,18.72±4.82,20.30±6.35,respectively.The levels of serum Cys-C and HCY are different among the four groups and the differences are of statistical significance(P<0.001).Through comparison among the groups,the level of Cys-C of the severe-stenosis group or the blocked group is higher than that of the non-stenossis group(P<0.001).The Cys-C level of the intermediate-stenosis group is higher than that of the non-stenosis group(P<0.001).The Cys-C level of the slight-stenosis group is higher than that of the non-stenosis group(P=0.034).The HCY level of the severe-stenosis group or the blocked group is higher than that of the non-stenosis group(P<0.001).The HCY level of the intermediate-stenosis group is higher than that of the non-stenosis group(P<0.001).The HCY level of the severe-stenosis group or the blocked group is higher than that of the slight-stenosis group(P=0.019).4.They are also grouped to non-lesion group,the 1-lesion group,the 2-lesion group and the multiple-lesion group according to the number of vascular lesions.The serum Cys-C values are 0.60±0.19,0.71±0.60,0.75±0.22,0.92±0.20,respectively.The serum HCY values are 13.80±3.83,17.20±5.35,18.91±5.35,19.20±5.19,respectively.The levels of serum Cys-C and HCY are different among the four groups and the differences are of statistical significance(P<0.001).Through comparison among the groups,the level of Cys-C of the multiple-lesion group is higher than that of the non-lesion group(P<0.001).The level of Cys-C of the multiple-lesion group is higher than that of the 1-lesion group(P<0.001).The level of Cys-C of the multiple-lesion group is higher than that of the 2-lesion group(P=0.045).The level of HCY of the multiple-lesion group is higher than that of the non-lesion group(P<0.001).The level of HCY of the 2-lesion group is higher than that of the non-lesion group(P=0.010).5.The correlation between the serum Cys-C and the degree of vascular stenosis(r=0.489,P<0.001)and the correlation between the serum Cys-C and the number of vascular lesions(r=0.571,P<0.001).6.The correlation between the serum HCY and the degree of vascular stenosis(r=0.493,P<0.001)and the correlation between the serum HCY and the number of vascular lesions(r=0.459,P<0.001).Conclusion:1.The high-risk factors,such as age,hypertension,diabetes and drinking history,exert influence on intracranial vessels in different apsects.2.The serum Cys-C and HCY are closely correlated to the atherosclerotic stenosis of intracranial vessels;3.The serum Cys-C and HCY are positively correlated with the occurrence of acute ischemic stroke. |
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