Correlation of hypertension with hyperhomocysteinemia and early neurological deterioration in patients with intracerebral hemorrhage / 国际脑血管病杂志

ABSTRACT

Objective:To investigate the relationship between hypertension with hyperhomocysteinemia (HHcy) and early neurological deterioration (END) in patients with intracerebral hemorrhage.Methods:Patients with acute intracerebral hemorrhage admitted to the Department of Neurology, the First People's Hospital of Huainan from January 2017 to December 2018 were enrolled prospectively. END was defined as the National Institutes of Health Stroke Scale (NIHSS) score increased by ≥4 or Glasgow Coma Scale (GCS) score decreased by ≥2 at any time within 72 h after onset from baseline. The baseline data of the END and non-END groups were compared, and multivariate logistic regression analysis was use to evaluate the independent risk factors for END. Results:A total of 238 patients with acute intracerebral hemorrhage were enrolled, and 64 of them (26.9%) developed END. The baseline hematoma volume, NIHSS score, blood glucose, homocysteine level, neutrophil count, and the proportion of hypertension, hemorrhage into ventricle and hematoma enlargement in the END group were significantly higher than those in the non-END group, while the baseline GCS score was significantly lower than that in the non-END group (all P<0.05). Multivariate logistic regression analysis showed that after adjusting for the confounding factors, the baseline hematoma volume (odds ratio [ OR] 1.086, 95% confidence interval [ CI] 1.029-1.146; P=0.003), baseline GCS score ( OR 0.420, 95% CI 0.245-0.719; P=0.002) and hypertension with HHcy ( OR 2.441, 95% CI 1.185-5.029; P=0.016) had significant independent correlation with END. Conclusion:Hypertension with HHcy is an independent predictor of END in patients with intracerebral hemorrhage.