Dissertation > Medicine, health > Neurology and psychiatry > Neurology > Cerebrovascular disease > Acute cerebrovascular disease ( stroke)

The Study of the Relationship between Homocysteine and Acute Cerebral Infarction

Author HuangShuLiang
Tutor GuoYi
School Jinan University
Course Neurology
Keywords cerebral infarction homocysteine folate vitamin B12
CLC R743.3
Type Master's thesis
Year 2009
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Objective To investigate the relationship between homocysteine and acute cerebral infarction, and to explore the effects of treatment of folate,methylcobalamin and vitamin B6 in the acute cerebral infarction patients with hyperhomocysteinemia(HHcy).Methods 544 acute cerebral infarction patients identified by brain MRI/CT were collected between January 2007 to December 2008.The patients were stratified according with their gender,serum folate,tHcy and TOAST respectively;correlation analysis and multiple linear regression analysis were used to determine the relationship between tHcy and HsCRP,serum lipid,folate,vitamin B12,creatinine,et al.There were 192 of TOAST 3 CI patients with adequate temporal acoustical window to analysis the relationship of MCA blood flow parameters and Hcy, vascular risk factors.168 acute cerebral infarction patients with HHcy were randomized divided into the treatment group and control group,all the patients in this two group were treated with the standard treatment program of cerebral infarction;the treatment group,in additional was also treated with folic acid,mecobalamin and vitamin B6 at least three month,the level of plasma Hcy,folate,vitamin B12 in this two group were inspected in two weeks and 3 months.The primary efficacy end points included NIHSS,BI,mRS and recurrence rate of stroke or vascular event at 3 month,。Results:No significant differences in the level of tHcy was found between the two groups divided by sex;the folic acid and vitamin B12 levels were significantly lower in patients with the level of tHcy>15μmol/l.level of tHcy was negatively correlated with folate,vitamin B12,and positively correlated with creatinine were found;level of were not correlated with IMT in patients of cerebral infaction.There were higher tHcy levels in patients of TOAST 1 and 2.There was no relationship identified between the level of tHcy and the middle cerebral artery hemodynamics in patients of TOAST 3;the level of tHcy in 168 patients with the level of tHcy>15μmol/L were decreased after 3 month.But more decreased were observed in patients of the treatment group.There were no difference in the Score of NIHSS,BI index and mRS in patients between the treatment and control group after 3 months.Conclusion:level of tHcy was correlated with folate,vitamin B12 and creatinine;higher tHcy level was observed in patients of TOAST 1 and 2;there was no relationship were found between the tHcy and the carotid intima-media thickness,and the hemodynamics of the brain MCA.Obviously effect of treatment of folate and vitamin B12 in decrease tHcy were found in patients of treatment group,but there was no difference were observed in the prognosis in this two groups.

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