ABSTRACT
Our meta-analysis focused on the relationship between homocysteine (Hcy) level and the incidence of aneurysms and looked at the relationship between smoking, hypertension and aneurysms. A systematic literature search of Pubmed, Web of Science, and Embase databases (up to March 31, 2020) resulted in the identification of 19 studies, including 2,629 aneurysm patients and 6,497 healthy participants. Combined analysis of the included studies showed that number of smoking, hypertension and hyperhomocysteinemia (HHcy) in aneurysm patients was higher than that in the control groups, and the total plasma Hcy level in aneurysm patients was also higher. These findings suggest that smoking, hypertension and HHcy may be risk factors for the development and progression of aneurysms. Although the heterogeneity of meta-analysis was significant, it was found that the heterogeneity might come from the difference between race and disease species through subgroup analysis. Large-scale randomized controlled studies of single species and single disease species are needed in the future to supplement the accuracy of the results.
Subject(s)
Aneurysm , Hyperhomocysteinemia , Hypertension , Homocysteine , Humans , Hyperhomocysteinemia/diagnosis , Hyperhomocysteinemia/epidemiology , PlasmaABSTRACT
BACKGROUND: Acute ischemic stroke (AIS) is mainly caused by cerebral blood flow disorders, which further leads to ischemic brain necrosis or encephalomalacia. The role of homocysteine (Hcy), an independent risk factor for cardiovascular disease, in the development of atherosclerosis is gradually revealed. However, studies are still rare and little is known about the relationship of Hcy level with the prognosis. AIM: To explore the relationship between Hcy level and prognosis in elderly patients with AIS after thrombolytic therapy with recombinant tissue plasminogen activator (rtPA). METHODS: A total of 120 patients with acute ischemic stroke who were admitted to Jingzhou Central Hospital and underwent recombinant tissue plasminogen activator treatment were randomly selected from January 2017 to December 2018. They were divided into two groups according to the level of Hcy, with 60 patients in each group. Patients with Hcy ≥ 18.54 umol/L were included into a high-level group and those with Hcy < 18.54 umol/L were included into a low-level group. The outcomes were analyzed in the two groups after the treatment. RESULTS: The National institute of Health Stroke Scale (NIHSS) scores were significantly higher in the high-level group than in the low-level group before and 1 h after the treatment (P < 0.05). There was no significant difference in NIHSS scores between the two groups at 12 and 24 h after the treatment (P > 0.05). The Modified Rankin scale (MRS) scores were significantly higher in the high-level group than in the low-level group before and 1 h after the treatment (P < 0.05). There was no significant difference in MRS scores between the two groups at 12 and 24 h after the treatment (P > 0.05). NIHSS and MRS scores were positively correlated with the prognosis after thrombolytic therapy (P < 0.05). CONCLUSION: The level of Hcy is closely related to the prognosis of elderly patients with acute ischemic stroke, and after rtPA treatment, the prognosis of elderly patients is improved significantly.
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Objective To investigate the effects of oxiracetam combined with Shuxuetong injection on hemorheology and serum Hcy levels in patients with cerebral infarction. Methods 60 patients with cerebral infarction were randomly divided into 2 groups, 30 cases in the observation group and were treated with oxiracetam combined with Shuxuetong injection. 30 cases in the control group were treated with Shuxuetong injection. The hemorheology and serum Hcy levels in the two groups were compared. Results After treatment, the hemorheological indexes and serum Hcy levels in the observation group were lower than those in the control group (P<0.05). The treatment effect of the observation group was better than that of the control group (P<0.05). The scores of neurological deficits in the observation group were significantly better than those in the control group (P<0.05). The number of complications in the observation group was 2 cases, the incidence of complications was 6.7%, which were significantly lower than 9(30.0%) in the control group, the differences between the two groups was statistically significant (P<0.05). Conclusion The application of oxiracetam combined with Shuxuetong injection in patients with cerebral infarction can effectively improve the hemorheology and reduce the serum Hcy level.
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Objective To study the correlation between serum homocysteine (Hcy) levels and chronic heart failure (CHF) with ultrasound cardiac function patients.Methods The subjects were 88 cases of CHF (CHF group) in our hospital between April 2014 to June 2015 between patients,selected 65 cases of healthy people as a control group over the same period in our hospital,using color Doppler ultrasound measurement of two groups patients of the left ventricular ejection fraction of patients groups (LVEF) and left ventricular end-diastolic diameter (LVEDd),and compared serum Hcy and NT-proBNP levels,LVEF and LVEDd in different NYHA classification patients,analysis of serum Hcy and NT-proBNP levels and LVEF,LVEDd between correlation of serum Hcy levels on cardiovascular incident.Results CHF group of the Hcy,NT-proBNP levels and LVEDd were significantly higher than control group (P ＜ 0.01),LVEF was significantly lower than the control group (t =31.78,P =0.00);different NYHA functional class (Ⅱ ～ Ⅳ level) of Hcy,NT-proBNP,LVEDd and LVEF compared were statistically difference (P ＜ 0.01);Pearson correlation analysis showed,CHF patients with LVEF serum Hcy levels were negatively correlated (r2 =0.974,P ＜ 0.01),with LVEDd was positively correlated (r2 =0.896,P ＜ 0.05),and higher serum Hcy levels,the higher the rate of cardiovascular happened in patients with CHF.Conclusion The serum Hcy and NT-proBNP levels in patients with CHF were significantly higher than healthy,and with the deterioration of heart function and increased while the LVEF was negatively correlated positively with LVEDd,cardiovascular events in high Hcy levels may also increase the incidence risk,so Hcy levels is expected as a new diagnostic marker CHF conditions change.
