| Objective:Stroke is one of the main causes of adult death and disability in my country.Cerebral infarction is the most common type of stroke.HHcy is an intervention that can cause stroke.Influencing factors,Methylenetetrahydrofolate reductase(MTHFR)participates in the methionine cycle to affect the level of homocysteine(Hcy)in the body and the absorption and utilization of folic acid.Therefore,this study analyzed the gene distribution of MTHFR C677 T in ischemic stroke patients with HHcy,and explored the Hyperhomocysteinemia content and the change range of Hcy in stroke patients with different genotypes of MTHFR C677 T before and after oral folic acid,as well as the range of changes in homocysteine in patients with each genotype.The successful rate of treatment provides a certain theoretical basis for individualized treatment of Hyperhomocysteinemia in clinical work.Methods:Continuously enrolled patients with cerebral infarction associated with HHcy who were hospitalized in the neurology department of Xianyang Hospital of Yan’an University from January 2019 to January 2020.A total of 152 patients meeting the criteria for inclusion and discharge were collected.According to the genotype of MTHFR C677 T,the patients are divided into three groups: A,B,and C,which are respectively CC genotype,CT genotype and TT genotype.All patients were given 5 mg of oral folic acid daily.The treatment period was 8 weeks.All participants After admission,the Hcy level and biochemical indicators such as blood sugar,blood lipids,and creatinine were detected.After 8 weeks of treatment,the Hcy level was tested again in our hospital.According to the Hcy level after the treatment,the Hcy level was divided into treatment success and failure groups.The general data and biochemical data of the enrolled patients were recorded by Excel,and SPSS 26.0 was used for data analysis to compare the therapeutic effects of HHcy patients with different genotypes of MTHFR C677 T taking high-dose folic acid.Results:1.Comparison of baseline data of the three groups of patients: gender,age,smoking and drinking history,BMI,blood pressure,blood sugar,uric acid,creatinine,urea nitrogen,and blood lipids were not statistically significant(P>0.05),balanced and comparable.2.MTHFR C677 T gene distribution characteristics: Among the 152 patients enrolled,40 patients of MTHFR C677 T genotype were CC patients,and the proportion of the total number of people is 26.32%;a total of 65 patients with CT genotype were enrolled,and the proportion of the total number of people is 42.76%;a total of 47 patients with TT genotype were enrolled,and the proportion of the total number of people is 30.92%;Respectively,the frequencies of C and T alleles were 47.7% and52.3%.3.The distribution of Hcy in patients with different genotypes of MTHFR C677 T in mild,moderate,and severely increased: the Hcy levels of the three groups of patients were not distributed in the severely increased range,and the Hcy levels of TT patients were distributed in moderately increased The proportion of the range was significantly higher than that of the CC group and the CT group,and the proportion of the slightly elevated range was significantly lower than that of the CC group and the CT group.4.The Hcy content was significantly correlated with the genetic polymorphism of MTHFR C677T(P<0.05).The Hcy content of patients in group C was higher than that of groups A and B,and the difference was statistically significant(P<0.05),while the difference between group A and group B There was no statistically significant difference in Hcy content between patients(P>0.05).5.The plasma Hcy level of the 152 selected patients before treatment was(22.30±6.45)μmol/L,and the plasma Hcy level after taking folic acid tablets 5 mg/d was(16.83±4.29)μmol/L.After 8 weeks of folic acid supplementation,the Hcy level of the patients was higher than the baseline level.Down by about 24.53%,the difference was statistically significant(P<0.05).6.After taking folic acid,the Hcy level of group C decreased the most,about 27%,which was significantly higher than that of groups A and B;but in terms of treatment success rate,group A had the highest treatment success rate,which was about 45%,which was higher than that of group B.In group C,the difference was statistically significant(P<0.05).Conclusion:1.The Hcy content of patients with TT type cerebral infarction is higher than that of CC and CT;2.In patients with HHcy,the plasma Hcy content decreased after supplementing with 5 mg of folic acid per day,with the TT type decreasing the most significantly;3.The success rate of CC genotype in MTHFR C677 T is higher than that of CT and TT type.The T allele increases the failure of folate treatment in HHcy patients. |
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