| Objective: Cerebral stroke has a higher incidence with high rates of disability and mortality in China.Most of the patients have sequelae and lose their ability to work.It is a heavy burden on the family.In recent years,the probability of a brain stroke in young man is elevated,so it is urgent to strengthen the prevention and treatment of cerebral infarction.In the case of a brain Infarction,it means that a narrowing or thrombosis in the brain's blood vessels caused the brain tissue to be deprived of oxygen,to have all kinds of clinical symptoms,which accounts for more than 70% of all types of stroke.At present,there are many risk factors for cerebral infarction,such as high blood pressure,diabetes,smoking or drinking alcohol over a long period of time,dyslipidemia,etc.China has a large population base and a large number of people with hypertension.In recent years,it has been found that Homocysteine(Hcy)is increased in a large proportion in patients with hypertension.Therefore,the idea of h-type hypertension was proposed.High homocysteine and hypertension interact with each other,which not only promotes the occurrence of arteriosclerosis,but also increases the incidence of stroke.Carotid artery ultrasonography has been used for a long time in neurology department.Ultrasound examination is cheap,simple,non-invasive and good compliance for patients,which is advantageous to the disease for a long time follow-up.Carotid vascular color Doppler ultrasonography is used to clearly display the blood flow of each segment of blood vessel.It can detect carotid atherosclerosis as early as possible,analyze the stricture of blood vessels in the neck,appearance and stability of plaque,etc,and give health guidance and treatment as early as possible.It can also provide accurate intracranial and extracranial vascular conditions for stroke patients,and provide reliable assistance for selecting the best clinical treatment scheme and check the data.D-dimer(DD)is the product of enhanced fibrinolysis,which is indicated to some extent that thrombus formation exists in the body.D-dimer has diagnostic significance in many thrombotic diseases,such as pulmonary embolism and venous thrombosis.Previous studies have shown that DD is elevated after a brain infarction,but the study is inconclusive.In this study,the effect of Homocysteine(Hcy)on the characteristics of carotid artery plaques in acute hypertensive cerebral infarction and d-dimer analysis were performed.In order to enhance the attention and treatment of H-type hypertension by the clinician,and to intervene early in patients with high-risk carotid plaque,which is of great significance in reducing the incidence of cerebral infarction and reducing the family economic pressure and social burden of patients.Materials & Methods: 1.Selected 138 patients with acute hypertensive cerebral infarction who were diagnosed and treated in neurology department of Baoding First Central Hospital of Hebei Province from April to December 2017.After excluding other basic diseases such as hyperlipidemia,diabetes mellitus,severe heart disease(atrial fibrillation)and long-term smoking.The patient had no cerebrovascular disease and had a definite onset time(within 72 hours).2.(1)Collect the general information of patients: age,sex and so on;basic diseases: hypertension,diabetes,heart disease;past history: history of smoking,history of drinking;laboratory data: blood lipids,homocysteine,D-dimer.(2)the patients were routinely examined by MRI(including DWI)after admission to make a clear diagnosis of cerebral infarction.Patients with clearly diagnosed hyperbaric cerebral infarction were divided into three groups according to the Hcy value: 46 cases in the group with higher Hcy(Hcy >30mmol/L),74 cases in the group with slightly higher Hcy(Hcy =15mmol/L ~ 30mmol/L),and 18 cases in the group with lower Hcy(Hcy<15mmol/L).(3)The patient was admitted to the hospital in three days with a carotid blood vessel,recording the number,the size and echogenicity of the carotid plaques.Patients were defined as those with higher risk of plaques:the moderate risk plaques and the low-grade risk plaques,and to classify the patients as high-risk patients,moderate risk patients,and low-risk patients.3.I have applied SPSS 21.0 statistical software to select appropriate statistical methods for statistical analysis.Result: High Hcy,moderately elevated Hcy and Hcy in patients with lower group in foundation data,at the age,gender,and high blood pressure values,were Less statistical significance(P > 0.05),which is comparable.The higher Hcy group(Hcy>30mmol/L)and the slight increase of Hcy Groups(Hcy=15mmol/L ~ 30mmol/L)and Hcy lower group(Hcy<15mmol/L)had high risk plaques,P<0.05,high risk in Hcy group(Hcy>30mmol/L)The degree of plaque has increased,It was found that there was a great likelihood of recurrence of cerebral infarction.There was no statistical difference in d-dimer between the group with higher Hcy,the group with slightly increased Hcy and the group with lower Hcy(P>0.05),and there was no difference in the content of d-dimer between the three groups.Conclusion: With the Hcy rising,The degree of risk of carotid plaques in hypertensive cerebral infarction may increase and the likelihood of a recurrence of cerebral infarction is greater.Hyperhomocysteinemia may contribute to the increase of carotid plaque instability and thus increase the probability of plaque shedding.D-dimer content in three groups of patients have no obvious difference,but D-dimer was only one of many coagulation factors family,which could not represent that HCY was not related to abnormal coagulation function in vivo.It can be seen that that high risk plaque of the carotid artery is timely detect when the patient is hospitalized,we can better determine the prognosis of patients,and timely communication and treatment are conducive to long-term high-quality survival of patients. |
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