Relationship Between Levels Of Hcy,GFR And UA And Carotid Atherosclerosis In Hypertensive Patients With Cerebral Infarction

Objective: To investigate the serum homocysteine(Homocysteine),glomerular rate filtering and Uric acid levels in patients with essential hypertension(EH)combined with infarction(Brain infarction)and carotid artery The relationship between atherosclerosis(Carotid atherosclerosis).METHODS: Patients with a history of hypertension who were admitted to the Department of Neurology,Affiliated Hospital of XX from October 2017 to December 2018,and who had symptoms of dizziness,headache,nausea,vomiting,and decreased limb muscle strength were selected.Among the subjects,184 patients with cerebral infarction and hypertension were selected as the experimental group by head CT or cranial MRI.74 patients with hypertension who were not admitted to the cerebral infarction were selected as the control group.All patients were recorded in detail.Clinical data such as name,gender,age,smoking history,and other relevant biochemical indicators such as fasting blood glucose,blood lipids,urea nitrogen(BUN),serum creatinine(Cr),glycosylated hemoglobin(Hb A1C),serum Hcy,uric acid(UA).The experimental group was divided into normal carotid artery group(CIMT<1.0mm)and carotid atherosclerosis group(CIMT≥1.0mm)according to carotid intima-media thickness value;it was divided into normal renal function group according to GFR level(GFR≥90m L)./(min.1.73m2),mild renal function loss group(60m L /(min.1.73m2)≤ GFR <90m L /(min.1.73m2)and moderate renal function decline group(GFR <60m L /(min.1.73 M2);Hcy was divided into three groups according to fasting serum Hcy level(group A: Hcy <10 mmol/L,group B: 10 mmol/L ≤ Hcy < 15 mmol/L,group C: Hcy ≥ 15 mmol/L).Logistic regression analysis was used to investigate the relationship between Hcy,GFR and UA levels and carotid atherosclerosis in patients with hypertension complicated with cerebral infarction.Results: 1.The serum Hcy,creatinine and cholesterol levels in the experimental group were higher than those in the control group,and plaque formation The rate was higher than that of the control group,and the high-density lipoprotein(HDL)was lower than the control group,the difference was statistically significant(P<0.05).Gender,age,smoking,drinking,glycated hemoglobin,urea nitrogen,uric acid,triglyceride,Low-density lipoprotein(LDL)was not statistically different between the two groups(P>0.05).Binary logistic regression was performed on the two groups.It is suggested that Hcy and carotid plaque formation are independent risk factors for cerebral infarction in patients with hypertension.HDL is a protective factor for cerebral infarction.2.Age,Hcy,creatinine,uric acid,urea nitrogen level in carotid atherosclerosis group Higher than the normal carotid artery group,the GFR level was lower than the normal group,the difference was statistically significant(P<0.05);and gender,smoking,drinking,blood sugar,glycosylated hemoglobin,triglyceride,cholesterol,LDL,HDL,body mass index(BMI)There was no statistical difference between the two groups(P>0.05).3.Grouped by Hcy level: creatinine,uric acid,urea nitrogen,male ratio,and plaque formation rate were higher in group C than in group A and group B.The GFR level was lower than that of group A and group B,the difference was statistically significant(P<0.05).The proportion of males in group B was higher than that in group A(P<0.05).The other indicators were not statistically significant(P<0.05).P>0.05);There was no significant difference in smoking,drinking,blood glucose,glycosylated hemoglobin,triglyceride,cholesterol,LDL,HDL and BMI among the three groups(P>0.05).4.Patients with moderate or severe renal function decline Hcy level,creatinine level,uric acid level The levels of urea nitrogen and plaque formation were higher than those with mild renal function and normal renal function.The age of middle and severe renal function was higher than that of normal renal function(P<0.05).Hcy levels,creatinine levels,uric acid levels,urea nitrogen levels,and plaque formation rates were significantly higher in the mild renal decline group than in the normal renal function group(P<0.05);smoking,drinking,and glycerol There were no significant differences in lipid,cholesterol,LDL,HDL and BMI between the three groups(P>0.05).5.Binary Logistic regression analysis of CIMT related cardiovascular risk factors showed that the increased Hcy,uric acid level and decreased GFR level were closely related to the thickening of CIMT(P<0.05),and independent of traditional cardiovascular risk factors。Conclusion: The formation of Hcy and carotid plaque is an independent risk factor for cerebral infarction in patients with hypertension.HDL is a protective factor for cerebral infarction.In patients with hypertension and cerebral infarction,with the increase of Hcy and uric acid levels,kidney The ball filtration rate decreased,CIMT thickened and plaque formation rate increased.