| objective The relationship between the levels of Homocysteine?Hcy?and Uric Acid?UA?in patients with Acute cerebral infarction?ACI?and the occurrence and development of ACI at the acute stage and its clinical significance were discussed.Methods Selection in October 2018 to June 2019 in department of Neurology of the First Affiliated Hospital of Shihezi University Medical College treated 160 cases of patients with acute cerebral infarction?ACI?as a case group and the other the same period 64 cases of healthy physical examination were selected as control group,collect all the objects of general data,including age,gender,height,weight,blood pressure,history of hypertension,diabetes,coronary heart disease history,history of smoking,drinking,etc.The case group was evaluated according to the NIHSS scoring scale,and the neurological impairment degree of the patients within 48h of onset could be divided into the mild group 53 cases?NIHSS score?7points?,the moderate group 67 cases?7 points<NIHSS score?19 points?,and the severe group 40 cases?NIHSS score>19 points?.For 7 days disease patient situation can be divided into basic recovery group?NIHSS score is within 48 h of the reduced by more than 91%,and muscle strength back to normal?,improved markedly group?NIHSS score is within 48 h of the reduced by 46%-90%,and muscle strength back to 4?,the improvement group?NIHSS score is within 48 h of the reduced by 18%-45%,and muscle recovery level 2-3?,invalid group?NIHSS score fell below 18%within 48 h of or aggravating,and strength without apparent recovery?.Serum Hcy and UA levels within 48h and day 7 of the onset of the case group were detected by enzyme cycling and uricase respectively,and the control group was detected only once to analyze the changes in serum Hcy and UA levels between the above groups.The relationship between serum Hcy,UA and ACI was studied by Logistic regression analysis.Results?1?There were no statistically significant differences in gender,age,body mass index?BMI?and drinking history between the case group and the control group?P>0.05?.There were statistically significant differences in the history of hypertension,diabetes,coronary heart disease and smoking?P<0.05?.?2?The serum Hcy level?17.054±4.970?and serum UA level?327.610±79.487?in the case group were significantly higher than that in the control group?13.108±2.326?and UA level?303.200±72.927?within 48 hours?P<0.05?.The serum Hcy level?17.446±4.977?increased on the 7th day of the disease?P<0.05?,and the serum UA level?260.850±71.410?decreased?P<0.05?.?3?Within 48h of onset,the serum Hcy level in the severe group?21.075±5.242?was higher than that in the moderate group?16.588±4.524?and the mild group?14.609±3.182??P=0.000?,and the moderate group was higher than that in the mild group?P=0.016?.The serum UA level of the severe group?378.500±66.408?was higher than that of the moderate group?318.910±86.525?and the mild group?300.210±60.453??P=0.000?,and the moderate group was higher than that of the mild group?P=0.349?.In the case group,the serum Hcy level?19.282±4.793?in the invalid group was significantly higher than that in the basic recovery group?16.279±4.346?and the significantly improved group?16.577±5.001?on the 7th day of the onset,with statistically significant differences?P<0.05?.The serum UA level of the invalid group?290.270±90.244?was significantly higher than that of the basic recovery group?238.620±46.814?and the significantly improved group?249.670±50.296?,with statistically significant differences?P<0.05?.?4?Logistic regression analysis showed that smoking,hypertension,diabetes,coronary heart disease and high Hcy level were risk factors for ACI?P<0.05?,while there was no statistical significance between high UA level and ACI?OR=1.772,P=0.344?.?5?in the case group,serum Hcy was positively correlated with UA level within 48h of onset?r=0.305,P=0.000?,and both were slightly correlated with the degree of neurological impairment(r?Hc? y=0.498,P?Hcy?=0.000,r?U? A=0.345,P?UA?=0.000).Conclusion The changes of serum Hcy and UA levels were related to the severity of the disease at the onset and the severity of the disease in the acute phase,which may be involved in the occurrence and development of ACI in the acute phase.In logistic regression analysis,smoking,hypertension,diabetes mellitus,coronary heart disease and high Hcy level were risk factors for ACI,while serum UA level and the risk of ACI may be non-linear,showing a U-shaped relationship. |
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