The Study Of Homocysteine And Related Risk Factors In The Patients With Type 2 Diabetes Mellitus Complicated By Acute Cerebral Infarction

Objective:To investigate the relationship between serum homocysteine levels and the degree of neurological deficits in patients with type 2 diabetes（T2DM）complicated with acute cerebral infarction（TA）,to study the risk factors of neurological deficit symptoms in TA patients,so it can reference to predict and evaluate the severe neurological deficits in severe TA patients.Methods:A total of 215 patients with TA who were admitted to Yongzhou Central Hospital（North Hospital）from October 2017 to October2019 were selected.According to whether the patients had moderate or severe neurological deficits,they were divided into:moderate to severe neurological deficits group（NIHSS score≥5 points,TA1 group）:111patients;mild neurological deficit group（NIHSS score≤4 points,TA2group）:105 patients.Collect the following data:duration of diabetes,BMI,hypertension,smoking,easurement of systolic and diastolic blood pressure.Automatic biochemical analyzer detection:homocysteine,fasting blood glucose,glycated hemoglobin,white blood cell count,cholesterol,riglyceride,highdensity lipoprotein,low-density lipoprotein,C-reactive protein,uric acid.Color Doppler ultrasound evaluation of carotid plaque.The NIHSS score evaluates the symptoms of neurological deficit.Statistical analysis was performed using SPSS 23.0 statistical software.Results:1.The percentage of patients with white blood cell count,LDL,CRP,HbA_1C,Hcy,and smoking in the TA1 group was higher than that in the TA2 group（all P<0.05）,T2DM patients with long-term diabetes and unstable carotid plaque are more likely to have moderate to severe neurological deficits（all P<0.05）.2.Multiple linear regression analysis showed that FPG（βvalue:0.283）,HbA_1C（βvalue:0.306）,and CRP（βvalue:0.148）were all influencing factors of Hcy（all P<0.05）,and theβvalue of HbA_1CC was the largest.3.Logistic regression analysis showed that Hcy（OR=1.914）,HbA_1C（OR=1.614）,CRP（OR=1.861）,and carotid plaque（OR=1.697）were the risk factors for combined moderate and severe neurological deficits,of which Hcy The OR value was larger.4.Hcy was positively correlated with HbA_1C（r_s=0.321）;Hcy was positively correlated with NIHSS score（r_s=0.521）;HbA_1CC was positively correlated with NIHSS score（r_s=0.359）;CRP and NIHSS score were linearly correlated（r_s=0.188）;Carotid plaque was positively correlated with NIHSS score（r_s=0.200）.Conclusions:1.Hcy,HbA_1C,CRP,and carotid plaque are risk factors associated in TA patients with moderate to severe neurological deficits,and among them,Hcy has a greater impact.FPG,HbA_1C,and CRP are all influencing factors of Hcy,and the influence of HbA_1CC is the largest;2.In TA patients,Hcy is positively correlated with HbA_1C,and Hcy,HbA_1C,CRP,and carotid plaque are positively correlated with NIHSS scores.