Study On The Relationship Between Cerebral Small Vessel Disease And Hyperhomocysteine

Objective:To explore the correlation between level of homocysteine(Hcy) and cerebral small vessel diseases(CSVD),to investigate the role of hyperhomocysteinemia(HHcy) in the occurrence and development of CSVD.Methods:108 patients with cerebrovascular disease in neurology department of our hospital from April 2017 to October 2018 were randomly selected as observation group(CSVD group).The observation group(CSVD group) was divided into lumen infarction group(LI group) 56 cases and white matter lesion group(WML group) 52 cases according to clinical manifestations and head MRI manifestations.Ninety health examinees who received routine examination in the same period were selected as control group.General data of all patients were collected:age,gender,previous history,smoking history,and fasting blood test indicators were recorded:total cholesterin(TC),triglyceride(TG),high denstiy lipoprotein(HDL),low denstiy lipoprotein(LDL),and homocysteine levels.The observation group with the control group,the LI group with the WML group were compared respectively,and SPSS21 statistical software was applied for data statistical analysis.The statistical methods involved in this paper are t-test,χ~2 test and logistic multivariate regression analysis,with P<0.05 as the difference.Results:1.The homocysteine(Hcy) level of the CSVD group(17.53±6.56μmol/L) was significantly higher than that of the control group(13.32±5.03μmol/L),and the difference was statistically significant(t=-4.99,P<0.05).There were also significant differences in age,hypertension and diabetes between the two groups(P<0.05).2.CSVD can be divided into two subgroups according to clinical manifestations and results of cranial magnetic resonance imaging:lumen infarction group(LI group) and white matter lesion group(WML group).The level of Hcy in LI group(16.12+6.47 umol/L) was lower than that in WML group(19.04+6.37 umol/L).The difference was significant(t=-2.36,P<0.05).The difference of age and TC between the two groups was also significant(P<0.05).3.Logistic multivariate regression analysis showed that elevated Hcy level may be an independent risk factor for CSVD(OR=1.118,P<0.05),and hypertension may also be an independent risk factor for CSVD(OR=2.816,P<0.05).4.Logistic multivariate regression analysis showed that elevated Hcy level may be an independent risk factor for LI(OR=1.090,P<0.05),and elevated Hcy level may also be an independent risk factor for WML(OR=1.176,P<0.05).5.When logistic regression was used to analyze LI and WML,it was found that although elevated Hcy level may be an independent risk factor for LI and WML,the risk degree of elevated Hcy level for WML patients(OR=1.176,P<0.05) was higher than that for LI patients(OR=1.090,P<0.05).At the same time,combined with table 2,the Hcy level of WML group(19.04+6.37 umol/L) was significantly higher than that of LI group(16.12+6.47 umol/L).It was found that the increase of Hcy level might be more related to WML.Conclusion:1.Compared with healthy people,the serum Hcy level of CSVD patients increased significantly.2.Compared with LI patients,serum Hcy levels in WML patients increased significantly.3.Increased levels of Hcy may be an independent risk factor for CSVD,LI and WML.4.Increased levels of Hcy may be more correlated with WML.