| Objective:To study the correlation of hyperhomocysteinemia(HHcy) and carotid atherosclerosis with progressive cerebral infarction(PCI), in order to provide new theoretical basis for the prevention and treatment of PCI.Methods:This study recruited 351 patients with acute cerebral infarction that hospitalized in December 2013-2014 period in December in the Affiliated Hospital of Binzhou Medical University, Department of Neurology as research subjects. All patients were divided into two groups:the progressive group (89 cases) and the non-progressive group(262 cases) based on the diagnostic criteria of PCI. According to the progressing time, the patients in the progressive group was divided into early-progressive group(59 cases) and the late-progressive group (30 cases). Enzyme-linked immunoassay (ELISA) was used to determine the level of Hcy and ultrasonic diagnosis instrument was applied to observe the carotid artery intima-media thickness and atherosclerotic plaques. Detailed records of all patients clinical data (gender, age, history of hypertension, diabetes, smoking history and drinking histories) and laboratory index results. Then analyze clinical data, Hcy level and the degree of carotid artery atherosclerosis of each group.Results:1. The patients with HHcy in each progressive group and non-progressive group were 79 (88.8%) and 176 (67.2%) respectively, the difference of the number between the two groups was statistically significant (?2=15.58, P<0.01).Patients with mild HHcy, moderate HHcy and severe HHcy in each progressive group and non-progressive group were 53 (67.1%),25 (31.6%),1 (1.3%) and 150 (85.2%),24 (13.6%),2 (1.1%) respectively, between the two groups elevated Hcy levels in patients was statistically significant (?2= 11.46, P<0.01).2. There were 56 (94.9%) patients with HHcy in early-progressive group and 23 (76.7%) patients in late-progressive group, the difference between the two groups was statistically significant (?2=6.238, P< 0.05).Patients with mild HHcy, moderate HHcy and sever HHcy in two groups were 34 (60.7%),21 (37.5%),1 (1.8%) and 19 (82.6%),4 (17.4%),0 (0%) respectively, no significant difference was found between them (?2= 4.147, P>0.05).3. Patients with internal carotid artery stenosis in progressive group and non-progressive group were 67 (75.3%) and 151 (57.6%); carotid artery stenosis rate difference between the two groups was statistically significant (?2= 8.791, P<0.01).Patients with mild, moderate, and severe carotid stenosis in the two groups were 18 (26.9%),21 (31.3%),28 (41.8%) and 70 (46.4%),43 (28.5%),38 (25.2%) respectively, and the difference between the two groups was statistically significant (?2= 8.735, P<0.05).4. Patients with mild, moderate, or severe carotid stenosis in early-progressive group and late-progressive group were 9 (15.3%),16 (27.1%),23 (39.0%) and 9 (30.0%),5(16.7%),5(16.7%) respectively, the difference between two groups was statistically significant (?2= 8.82, P<0.05).5. The soft plaque, hard plaque, or mixed plaque number detected in progressive group and non-progressive group were 25 (33.8%),23 (31.1%),26 (35.1%) and 36 (23.1%),85 (54.5%),35 (22.4%) respectively. And the difference was statistically significant (?2= 11.08, P<0.01).6. The soft plaque, hard plaque, or mixed plaque number detected in early-progressive group and late-progressive group were 19 (37.3%),11 (21.6%),21 (41.2%) and 6 (26.1%),12 (52.2%),5 (21.7%) respectively, the difference between two groups was statistically significant (?2=7.07, P<0.05).7, Interaction analysis:HHcy and carotid artery stenosis plays a synergistic role in the occurrence of PCI, the effect is greater than that of above sum up.Conclusion:1. HHcy, carotid stenosis and atherosclerotic plaque formation are all important risk factors of PCI.2. There are significant relativity between HHcy, artery stenosis, the type of atherosclerotic plaque and progressive cerebral infarction progressive time. Higher level of Hcy, more serior the narrow of carotid and vulnerable plaque contributes to cerebral infarction progress in early time.3. HHcy with carotid stenosis have synergistic effect for PCI, their co-existence plays a combined effect that is greater than two separate existence effect for PCI. |
PDF Full Text Request