Correlation Analysis Of Homocysteine And Internal Carotid Artery Stenosis With Acute Cerebral Infarction

Objective:To investigate the relationship between homocysteine and internal carotid stenosis in patients with acute cerebral infarction.Methods:A total of 170 patients with acute cerebral infarction who were admitted to the the Fourth Department of Neurology,the Fourth Affiliated Hospital of China Medical University from September 2016 to October 2017 were enrolled.Carotid artery color Doppler ultrasonography was used to detect the degree of internal carotid stenosis and carotid plaque.Hcy level.According to the difference of serum Hcy level,the patient was divided into Hcy normal group?Hcy?15?mol/L?and Hcy elevated group?Hcy>15?mol/L?with serum Hcy15?mol/L as the critical point;the merged from Hcy normal group In patients with diabetes and/or hypertension,the serum Hcy10?mol/L was used as the critical point,and the Hcy normal group was further divided into Hcy critical high value group?10?mol/L<Hcy?15?mol/L?and Hcy critical low value group.?Hcy?10?mol/L?,compare general clinical data of Hcy normal group and Hcy elevated group,including gender?male?,age,smoking history,history of hypertension,history of diabetes,fibrinogen?Fg?,triglyceride?TG?,total cholesterol?TC?,low density lipoprotein?LDL?,high density lipoprotein?HDL?,blood vitamin B₁₂,folic acid;comparison of Hcy normal group and Hcy elevated group,Hcy critical high value group and Hcy the number and stability of internal carotid plaques in the critical low-value group,as well as the degree of internal carotid vascular stenosis in the extracranial segment.Results:?1?There were significant differences in gender?male?,hypertension ratio,diabetes ratio,vitamin B₁₂2 and folic acid levels between the patients with acute cerebral infarction and those with Hcy?P=0.024,P=0.040,P=0.033,P=0.000,P=0.014?,the above factors were included in the multivariate logistic regression analysis.The results showed:gender?male??95%CI:1.007-3.981,OR=2.002,P=0.048?,hypertension?95?%CI:0.895-3.788,OR=1.841,P=0.047),diabetes?95%CI:1.002-3.751,OR=1.938,P=0.049?and vitamin B12?95%CI:0.002-0.006,OR=1.004,P=0.001?and folic acid?95%CI:0.013-0.236,OR=1.133,P=0.029?were significantly correlated with serum Hcy levels in patients with acute cerebral infarction?P<0.05?.?2?The detection of vascular plaques in patients with acute cerebral infarction,the detection rate of plaques in the serum Hcy group,the number of plaques and the number of unstable plaques were higher than those in the normal group.The difference between the two groups was statistically significant.?P=0.035,P=0.001?.In patients with acute cerebral infarction,the extracranial internal carotid artery stenosis was compared.The rate of mild vascular stenosis was lower in the Hcy group than in the normal group.The moderate and severe stenosis rate in the Hcy group was significantly higher than that in the normal group,and the difference was statistically significant.?P=0.001?.?3?The detection rate of plaques in the Hcy critical high-value group and the number of plaques and unstable plaques were higher than those in the Hcy critical low-value group.The difference between the two groups was statistically significant?P=0.028,P=0.035?.The internal cranial stenosis of the extracranial segment was further compared between the two groups.The results showed that the mild vascular stenosis rate was lower than the Hcy critical low value group,and the moderate and severe extracranial internal carotid stenosis rate Hcy.The critical high value group was significantly higher than the Hcy critical low value group,and the difference was statistically significant?P=0.032?.Conclusion:?1?Sex?male?,hypertension,diabetes,blood vitamin B12 and folic acid levels were associated with serum Hcy levels with acute cerebral infarction,suggesting that they may be risk factors for acute cerebral infarction.?2?With the increase of serum Hcy level,the degree of internal carotid artery stenosis increased and the number of unstable plaques increased significantly,suggesting that serum Hcy levels are closely related to carotid atherosclerosis.?3?Acute cerebral infarction with hypertension and/or diabetes,serum Hcy is at risk of atherosclerosis at 10-15?mol/L,suggesting that serum Hcy>10?mol/L requires intervention.