Correlation Between Levels Of Serum Homocystein,High Sensitivity C-reactive Protein And Subtypes Of Atherosclerosis Ischemic Stroke

BackgroundAs a common cerebrovascular disease,ischemic stroke not only causes physical disability but also leads to cognitive impairment,and the age of onset is getting younger and younger.The etiology of ischemic stroke is complex,the clinical manifestations and prognosis are different based on different etiologies,and the treatment scheme is different,too.TOAST subtype classification standard is one of the common etiological classification of ischemic stroke,the theory of classification of large and small vascular lesions plays a big role in the pathogenesis of research,it is helpful for doctor to treat different subtypes patients with individual treatment by using TOAST classification standard,in order to improve prognosis and reduce disability.Serum homocystein(Hcy)and high sensitivity c-reactive protein(hs-CRP)are commonly used as clinical indicators,and several studies have shown that they are closely related to stroke occurrence and regression.This study observed Hcy,hs-CRP dynamic evolution process and the imaging findings of different subtypes,analyzed Hcy,hs-CRP in different subtypes,then discussed the relationship between Hcy?CRP and ischemic stroke subtypes.In order to provide reference for clinical classification.ObjectivesTo investigate the differences of Hcy,hs-CRP on large-artery atherosclerosis and small vessel occlusive IS,and the association between Hcy,hs-CRP and each subtype of IS.MethodsA total of 217 participants with large-artery atherosclerosis(LAA)ischemic stroke(n=130)and small artery occlusive(SAO)ischemic stroke(n=87)based on TOAST were recruited in this study.The group of LAA included progressive stroke(PS)(n=58)).There was 12 PS patients in SAO ischemic stroke group.The level of serum Hcy and hs-CRP concent were measured and compared between two groups.Results1.Hcy,hs-CRP and low density lipoprotein(LDL)were significantly different in the LAA and SAO groups by logistic regression analysis [Hcy,P<0.019],[ hs-CRP,P=0.021],[LDL,P=0.012].[Hcy,P <0.019 ],the levels of serum Hcy,hs-CRP and LDL in the LAA stroke group were significantly higher than those in the SAO group;2.Hcy,hs-CRP and LAA were significant difference after correction of mixed factors in progressive and complete stroke [Hcy,P<0.001],[hs-CRP,P=0.017],[LAA,P=0.023],Serum levels of Hcy,hs-CRP and LAA were significantly higher in all patients with progressive stroke than those with complete stroke;3.There was no significant difference of the levels of Hcy between PS and complete stroke in LAA,while the levels of hs-CRP were higher in PS.ConclusionsHcy,hs-CRP and LDL are the independent risk factors of LAA stroke.Hcy,hs-CRP and LDL can be used as one of the indicators of IS classification.Hcy,hs-CRP and LAA are the independent risk factors of progressive stroke factor.