Relationship between homocysteine and early neurological impairment severity and prognosis of acute cerebral infarction

doi:10.3969/j.issn.1004-583X.2021.01.007

Abstract

Abstract:

Objective Homocysteine(Hcy) serves as main risk factor for cerebral infarction, especially for large artery atherosclerosis (LAA) cerebral infarction. The relations between Hcy, severity and prognosis of early neurological impairment in patients with LAA were clinically studied. Methods A total of 260 patients with LAA acute cerebral infarction(ACI) were selected, the degree of neurological impairments of patients at admission was evaluated (mild NIHSS≤5 points, moderate to severe NIHSS>5 points) according to the National Institutes of Health Stroke Scale (NIHSS); the fasting serum Hcy level within 24 hours was tested, and the patients were divided into high Hcy group (Hcy≥10 μmol/L) and normal Hcy group (Hcy<10 μmol/L); the follow-up for 90 days was implemented to record the prognosis, the correlation between the serum Hcy level and severity or prognosis of early neurological impairments in ACI was analyzed. Results The serum Hcy level in patients with moderate or severe ACI was higher than that of patients with mild cerebral infarction (P<0.01); The serum Hcy level in patients with poor prognosis was significantly elevated (P<0.01), and binary logistic regression analysis showed that elevated Hcy level was an independent risk factor for higher severity of neurological impairments in early stages of ACI (P<0.01; OR=1.387, 95%Cl: 1.245-1.545) and an independent risk factor for poor prognosis (P<0.01; OR=1.478, 95%Cl: 1.312-1.666). Conclusion Elevated serum Hcy level may be an independent risk factor for early deterioration of neurological function and poor prognosis of LAA in ACI.

Key words: homocysteine, brain infarction, neurological deficit, prognosis

CLC Number:

R743.33

Gong Tao, Gao Yun, Hu Yueyuan, Wang Dongyu. Relationship between homocysteine and early neurological impairment severity and prognosis of acute cerebral infarction[J]. Clinical Focus, 2021, 36(1): 35-38.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2021.01.007

https://huicui.hebmu.edu.cn/EN/Y2021/V36/I1/35

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References 22

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项目	严重程度		χ²/t值	P值	预后		χ²/t值	P值
项目	轻度(n=147)	中重度(n=113)	χ²/t值	P值	良(n=151)	不良(n=109)	χ²/t值	P值
男性[例(%)]	86(58.50)	81(71.70)	4.83	<0.05	88(58.30)	79(72.50)	5.56	<0.05
年龄(岁)	65.19±10.13	68.98±11.15	-2.83	<0.01	65.67±10.00	68.46±11.52	-2.08	<0.05
吸烟[例(%)]	49(33.30)	47(41.60)	1.87	>0.05	49(32.50)	47(43.10)	3.09	>0.05
高血压[例(%)]	89(60.50)	80(70.80)	2.95	>0.05	91(60.30)	78(71.60)	3.55	>0.05
糖尿病[例(%)]	55(37.40)	42(37.20)	0.00	>0.05	58(38.40)	39(35.80)	0.19	>0.05
高脂血症[例(%)]	91(61.90)	62(54.90)	1.31	>0.05	92(60.90)	61(56.00)	0.64	>0.05
高Hcy血症[例(%)]	89(60.50)	105(92.90)	35.36	<0.01	91(60.30)	103(94.50)	39.16	<0.01
收缩压(mmHg)	149.68±19.42	154.93±21.92	-2.01	<0.05	150.01±19.64	154.67±21.81	-1.77	>0.05
舒张压(mmHg)	87.10±10.84	87.70±11.07	-0.44	>0.05	86.87±10.61	88.04±11.36	-0.84	>0.05
葡萄糖(mmol/L)	7.32±2.91	7.43±2.98	-0.31	>0.05	7.36±2.97	7.38±2.90	-0.06	>0.05
甘油三酯(mmol/L)	1.81±0.78	1.80±0.84	0.09	>0.05	1.83±0.84	1.77±0.77	0.61	>0.05
胆固醇(mmol/L)	4.29±0.88	4.39±0.74	-1.02	>0.05	4.29±0.90	4.39±0.70	-0.98	>0.05
低密度脂蛋白胆固醇(mmol/L)	2.99±0.79	3.03±0.72	-0.36	>0.05	2.97±0.78	3.06±0.72	-0.95	>0.05
高密度脂蛋白胆固醇(mmol/L)	1.24±0.29	1.20±0.29	1.16	>0.05	1.23±0.29	1.21±0.30	0.55	>0.05

项目	严重程度		χ²/t值	P值	预后		χ²/t值	P值
项目	轻度(n=147)	中重度(n=113)	χ²/t值	P值	良(n=151)	不良(n=109)	χ²/t值	P值
男性[例(%)]	86(58.50)	81(71.70)	4.83	<0.05	88(58.30)	79(72.50)	5.56	<0.05
年龄(岁)	65.19±10.13	68.98±11.15	-2.83	<0.01	65.67±10.00	68.46±11.52	-2.08	<0.05
吸烟[例(%)]	49(33.30)	47(41.60)	1.87	>0.05	49(32.50)	47(43.10)	3.09	>0.05
高血压[例(%)]	89(60.50)	80(70.80)	2.95	>0.05	91(60.30)	78(71.60)	3.55	>0.05
糖尿病[例(%)]	55(37.40)	42(37.20)	0.00	>0.05	58(38.40)	39(35.80)	0.19	>0.05
高脂血症[例(%)]	91(61.90)	62(54.90)	1.31	>0.05	92(60.90)	61(56.00)	0.64	>0.05
高Hcy血症[例(%)]	89(60.50)	105(92.90)	35.36	<0.01	91(60.30)	103(94.50)	39.16	<0.01
收缩压(mmHg)	149.68±19.42	154.93±21.92	-2.01	<0.05	150.01±19.64	154.67±21.81	-1.77	>0.05
舒张压(mmHg)	87.10±10.84	87.70±11.07	-0.44	>0.05	86.87±10.61	88.04±11.36	-0.84	>0.05
葡萄糖(mmol/L)	7.32±2.91	7.43±2.98	-0.31	>0.05	7.36±2.97	7.38±2.90	-0.06	>0.05
甘油三酯(mmol/L)	1.81±0.78	1.80±0.84	0.09	>0.05	1.83±0.84	1.77±0.77	0.61	>0.05
胆固醇(mmol/L)	4.29±0.88	4.39±0.74	-1.02	>0.05	4.29±0.90	4.39±0.70	-0.98	>0.05
低密度脂蛋白胆固醇(mmol/L)	2.99±0.79	3.03±0.72	-0.36	>0.05	2.97±0.78	3.06±0.72	-0.95	>0.05
高密度脂蛋白胆固醇(mmol/L)	1.24±0.29	1.20±0.29	1.16	>0.05	1.23±0.29	1.21±0.30	0.55	>0.05

组别	例数	易损斑块	非易损斑块	内膜增厚
高Hcy组	194	127(65.50)	35(18.00)	32(16.50)
正常Hcy组	66	18(27.30)	30(45.50)	18(27.30)

组别	例数	易损斑块	非易损斑块	内膜增厚
高Hcy组	194	127(65.50)	35(18.00)	32(16.50)
正常Hcy组	66	18(27.30)	30(45.50)	18(27.30)

组别	例数	Hcy( μmol/L)
易损斑块	145	16.23(12.77-23.01)^*#
非易损斑块	65	10.16(8.84-12.38)
内膜增厚	50	11.79(9.37-13.49)
U值		71.221
P值		<0.01