Risk Factors Of Lacunar Infarction And Critical Values Of Homocysteine,uric Acid

Objectives:To explore the correlation between Homocysteine(Hey),Uric Acid(UA)and Lacunar Infarction(LI),to provide clinical prediction of risk factors that may cause lacunar infarction,and to determine its critical value,thus providing new ideas for the prevention and treatment of lacunar infarction.MethodsrFrom September 2016 to September 2018,302 patients with lacunar infarction hospitalized in the department of neurology of the affiliated hospital of Hebei university of engineering were selected as lacunar infarction group(LI group),117 patients with normal parallel cranial magnetic resonance plain scan and meeting exclusion criteria hospitalized in the department of neurology during the same period were selected as control group,the subjects were tested for serum Hey,UA and other conventional biochemical indexes and cranial magnetic resonance plain scan after admission,the general clinical data of all subjects were recorded in detail,and the experimental data were statistically analyzed by SPSS20.0 statistical software package.ResultsrFor the general clinical data of LI group and control group,in single factor analysis,there are significant differences in age,CHO,LDL-C,TG,HDL-C,Lp(a),Hey,UA,Cys-C,fasting blood glucose,hypertension history and coronary heart disease history between the two groups(P<0.05),while there are no significant differences in gender,drinking history,smoking history,TBIL5 D_BIL,IB,GGT,FIB,ApoA and ApoB(P>0.05);Multivariate binary Logistic regression analysis showed that hypertension history,age,CHO,LDL-C,TG,Lp(a),Hey,UA and fasting blood glucose were independent risk factors for LI(P<0.05),HDL-C was protective factor for LI(P<0.05);In binary Logistic regression analysis,statistically significant risk factors were ranked as hypertension history>fasting blood glucose>LDL-C>age>CHO>Hcy>TG>UA>Lp(a)according to their OR values;Hey and UA drew Roc curve and determined the critical value.The results showed that the area under the Roc curve of Hey was 0.750(95%confidence interval:0.698-0.802,P=0.000),with the maximum value of Youden index(sensitivity+specificity-1)as the optimal critical value.The critical value of Hey for diagnosing lacunar infarction was 11.36umol/L,Youden index was 0.408,corresponding sensitivity was 81.8%,specificity was 59%;The area under Roc curve of UA is 0.653(95%confidence interval:0.598-0.708,P=0.000).The critical value of UA for diagnosing lacunar infarction is 367.50umol/L,the Youden index is 0.248,the corresponding sensitivity is 30.8%,and the specificity is 94%.Conclusions:LI is the result of multiple factors,among which hypertension history,age,CHO,LDL-C,TG,Lp(a),Hey,UA and fasting blood glucose are the independent risk factors of LI.the order of risk degree of LI is hypertension history>fasting blood glucose>LDL-C>age>CHO>Hcy>TG>UA>Lp(a),HDL-C is the protective factor of LI;Determination of Hey and UA levels have diagnostic value for lacunar infarction.