Relativity Between Serum Homocysteine Level And Cerebral Microbleeds In Patients With Acute Ischemic Stroke

Objective: To explore the relationship between serum homocysteine(Hcy)and cerebral microbleeds(CMBs)in patients with acute ischemic stroke(AIS).Methods: The clinical data of AIS patients hospitalized in the People's Hospital of Liaoning Province from April 2017 to March 2018 were collected.According to whether there were CMBs,people were divided into: CMBs positive group and CMBs negative group.Clinical data were collected including age,gender,history of hypertension,history of diabetes,history of coronary heart disease,history of atrial fibrillation,history of smoking,history of drinking,history of previous ischemic stroke and history of drug use(including antiplatelet,anticoagulation,statin and other drugs).Laboratory tests included serum triglyceride(TG),total cholesterol(TC),high-density lipoprotein(HDL),low-density lipoprotein(LDL),apolipoprotein(Apo),uric acid(UA),Hcy,fibrinogen(FIB)and serum creatinine(Scr).MRI was used to diagnose AIS and evaluate the imaging findings such as CMBs and LA.According to the number of CMBs and the location,the severity and location were grouped further.Data processing was performed using SPSS 20.0 statistical software.Logistic multivariate regression analysis and Spearman analysis were used to explore the relativity between serum Hcy levels and CMBs in patients with AIS.Result: A total of 134 patients with AIS were enrolled,aged from 40 to 89 years,including 88 males(65.7%)and 46 females(34.3%).64(47.8%)cases were in CMBs positive group and 70(52.2%)cases were in negative CMBs.CMBs had a higher incidence in patients with AIS.In the CMBs positive group,there were 16 cases in the lobar group,16 cases in the deep/infratentorial group and 32 cases in the mixed group.The mixed part was the common site of CMBs.According to the severity classification,34 cases were mild,19 cases were moderate and 11 cases were severe.Those with mild or moderate CMBs were the main ones among the AIS patients.Univariate analysis showed that the history of hypertension,the history of previous ischemic stroke,the serum Hcy level and the Fazekas score in the CMBs positive group were higher than those in the CMBs negative group(P<0.05).Multivariate logistic regression analysis showed that serum Hcy levels(OR=1.068,95%CI=1.002-1.139,P=0.043)and Fazekas score(OR=1.320,95% CI = 1.024-1.701,P = 0.032).They were independent risk factors for CMBs.Spearman analysis showed a slight positive correlation between serum Hcy levels and CMBs(r=0.182,P=0.035).The Fazekas score of the mixed group was significantly higher than that of the lobar group and the deep/infratentorial group(P<0.05).The Fazekas score in the moderate and severe group were higher than that in the mild group,and the difference was statistically significant(P<0.05).Conclusion: 1.CMBs had a higher incidence in patients with AIS,and serum high Hcy levels was an independent risk factor of CMBs in patients with AIS,but had a slight positive correlation with the risk of CMBs.2.The mixed CMBs was a common kind of CMBs and the serum Hcy level was the highest in the mixed group(mixed group>deep/infratentorial group>lobar group),but the difference between the three groups were not statistically significant.And the Fazekas score was significantly higher than that of the lobar group and the deep/infratentorial group.3.CMBs grouped by focus numbers was mainly mild and moderate CMBs in patients with AIS.The severity of CMBs was related to the Fazekas score: severe group>moderate group>mild group.There was no significant association between serum Hcy levels and the severity of CMBs.