Serum Homocysteine Research Articles

Correlation of Serum Homocysteine Levels and Hyperinsulinaemia with Body Mass Index in Polycystic Ovarian Syndrome.

ABSTRACTBackground:Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies affecting women in reproductive age group. The interrelationship of serum homocysteine, homoeostatic assessment of insulin resistance (HOMA-IR) and body mass index amongst overweight, obese and non-obese PCOS patients is not fully established.Aims:We aimed to study the correlation of serum homocysteine levels and hyperinsulinaemia with body mass index (BMI) in PCOS patients.Study Setting and Design:This was a case–control study in which 35 women with PCOS and 35 non-PCOS women acting as controls were enrolled.Materials and Methods:Cases were identified by Rotterdam's criteria. (IR) indices, HOMA determination and serum homocysteine levels were determined and their correlation with BMI was studied.Statistical Analysis Used:Student's t-test and analysis of variance test were used for statistical analysis. The Pearson correlation coefficient was then used to estimate the correlation.Results:On overall evaluation, a significant positive correlation of fasting insulin, HOMA-IR and serum homocysteine) was observed (P < 0.05), however, on evaluating the correlation of these markers independently in cases and controls, only fasting insulin and HOMA-IR showed a significant correlation. In a multivariate model where PCOS was considered a dependent variable with age, fasting glucose, HOMA-IR, serum homocysteine and body mass index as the independent variables, only serum homocysteine levels were found to be significantly associated with the dependent variable (odds ratio = 1.172; 95% confidence interval = 1.032–1.330).Conclusion:PCOS women had significantly higher mean fasting glucose, fasting insulin, HOMA-IR and homocysteine levels as compared to non-PCOS controls. Mean HOMA-IR, homocysteine and fasting insulin levels showed a significant incremental trend with increasing BMI category in overall evaluation as well as in cases and controls independently.

A cross-sectional study of comparison of elevated levels of serum Homocysteine in intracranial and extracranial atherosclerotic stenosis groups.

Introduction: The primary goal of this study was to compare serum homocysteine levels in acute ischemic strokes caused by extracranial atherosclerotic stenosis (ECAS) and intracranial atherosclerotic stenosis (ICAS)groups in order to see if there was a link between elevated serum homocysteine levels and ICAS. Methodology: The present study was a cross-sectional study done by the department of neurology at a tertiary level hospital in Mumbai. Various clinical, radiological &amp; laboratory parameters including serum Homocysteine were compared between patients with ECAS and ICAS stroke. Results: The study enrolled a total of 150 patients, with 110 in the ECAS group and 40 in the ICAS group. We observed that mean serum Homocysteine levels were 2.42 µg/ml in the ECAS group and 4.88 µg/ml in the ICAS group (p=0.01). High serum Homocysteine levels were more common in the ICAS group than in the ECAS group (55 percent versus 33.6 percent, p = 0.01). The lipid profile was found to be similar in the two study groups, except for low HDL, which was observed in 70 (64%) of the ECAS patients as compared to 17 (43%) of the ICAS (p-value &lt; 0.05). There was no statistical difference in the caparison of demographic and other risk factor profiles between ECAS and ICAS patients. Conclusions: High serum Homocysteine levels were found to be more common in the ICAS group than in the ECAS group.

Serum homocysteine in intracerebral hemorrhage: A savior or a destroyer?

Objectives: Intracerebral hemorrhage (ICH) is more common in the Indian subcontinent compared to the Western world and associated with significant morbidity and mortality. Hence, all possible modifiable factors should be searched and steps taken so that a single opportunity is not missed in preventing such a catastrophe. The aim of the study is to find out whether homocysteine and Vitamin B12 are related to ICH. Materials and Methods: We included acute ICH patients of 18 years and above who came to our institute and got admitted in 5 months (September 2021–January 2022). Our team noted the demographics, National Institutes of Health Stroke Scale (at admission and discharge) and other clinical parameters. Volume and site of the intracerebral hematoma (from the initial computed tomography [CT] scan of the brain) were noted. The outcome and prognostic markers like Modified Rankin Scale (mRS) at discharge, MRS at 3 months (also MRS at admission) and ICH score were calculated. The blood parameters, including serum homocysteine and Vitamin B12 level, were noted post admission in hospital. Results: We found out of 44 ICH patients; ten patients had hyperhomocysteinemia (HHcy): 22.72%. We detected significant correlation between HHCy with ICH score (inverse relationship) and dyslipidemia (direct relationship). Conclusion: We found an inverse correlation between serum homocysteine level and ICH score, which shows a short-term (1 month) prognosis. This might hint that homocysteine might have a protective role to play in ICH. However, we probably need larger study population to find a correlation strong enough so that we can make a stronger conclusion.

Relationship among Serum Homocysteine, Intercellular Adhesion Molecule-1, Monocyte Chemoattractant Protein-1, and Visual Impairment in Diabetic Macular Edema.

To determine the relationship among serum homocysteine (Hcy), intercellular adhesion molecule-1 (ICAM-1), monocyte chemoattractant protein-1 (MCP-1) and visual impairment in patients with diabetic macular edema (DME). Cross-sectional analytical study. Yulin Second Hospital, China, from April 2018 to May 2021. A total of 132 patients with diabetic retinopathy (DR), complicated with DME, were selected as observation group; and 132 patients with simple DR were included in the control group. According to visual examination, patients in observation group were divided into visual disability and non-visual disability. Serum Hcy, ICAM-1, MCP-1, and other indicators were measured. Duration of diabetes, levels of serum Hcy, ICAM-1 and MCP-1 in observation group were higher than those in control group (all p <0.001). Levels of serum Hcy, ICAM-1 and MCP-1 in patients with mild, moderate and severe DME were significantly different (all p <0.001). Levels of serum Hcy, ICAM-1 and MCP-1 in patients with visual disabilities were higher than those in patients with non-visual disabilities (all p <0.001). Levels of serum Hcy, ICAM-1 and MCP-1 in visually disabled patients were higher than those in non-visual disability patients (all p <0.001). Levels of serum Hcy, ICAM-1 and MCP-1 in patients with DR complicated with DME were higher than those without visual disability; and levels of Hcy, ICAM-1 and MCP-1 in patients with visual disability were higher than those without visual disability. In patients with DR complicated with DME, increase of these serum markers may play an important role in visual disability. Key Words: Diabetic retinopathy (DR), Diabetic macular edema (DME), Hcy, ICAM-1, MCP-1, Visual impairment.

Relevance of Geographical and Biochemical Factors in Causation of Cerebral Venous Sinus Thrombosis: An Observational Analytical Study.

There is a higher prevalence of cerebral venous sinus thrombosis (CVST) in more recent times, owing to increased awareness, clinical diagnostic skills, and advancements in neuroimaging modalities. This study aimed to identify and characterize the geographical, clinical, and etiological profiles of patients with CVST that may be relevant to planning appropriate diagnostic and therapeutic strategies to improve functional recovery. A retrospective observational study was carried out at a tertiary care hospital between March 2014 and October 2018. The demographics and clinical profile of the hospitalized patients were extracted from the Medical Record Division. Choropleth maps were created to present the geographic distribution of the patients with CVST admitted to our hospital. A total of 145 patients with CVST were included in the study. Etiological factors revealed striking abnormalities in red blood cells counts and serum homocysteine. Analyzing the geographical distribution of the patients with CVST showed most of the patients hailed from Central Karnataka Plateau 106 (73%). Polycythemia was most commonly seen in patients residing in the Central Karnataka Plateau 21 (62%). It is inferred that large scale community-based studies to identify a genetic abnormality like a mutant erythropoietin gene should be undertaken to plan effective diagnostic, therapeutic, and preventive measures.

DO ANDROGENS PREDICT CARDIOVASCULAR RISK INCLUDING CARDIOTROPHIN-1 LEVELS in PATIENTS WITH OBESE and LEAN POLYCYSTIC OVARY SYNDROME.

We aimed to investigate Cardiotrophin-1 (CT-1) levels along with other markers of cardiovascular disease and the association of androgen levels with these parameters in both lean and overweight or obese PCOS patients. The study included 90 overweight or obese PCOS patients with metabolic syndrome (MS) and 80 lean PCOS patients without MS. The control group consisted of 140 healthy females. Anthropometric measurements, plasma glucose, insulin, lipid and hormone profile, homocysteine, hs-CRP, CT-1 levels and carotid-IMT were evaluated in all study subjects. Fasting insulin, HOMA values were significantly higher in obese PCOS patients. Total testosteron levels were higher in both PCOS groups with respect to both controls. Serum homocysteine, hs-CRP, CT-1 and carotid-IMT values were significantly higher in both PCOS groups compared to controls (p=0.001, pCIMT: 0.005). CT-1 was positively correlated with insulin, HOMA, total testosterone, homocysteine, hs-CRP and carotid IMT. After multiple regression analysis, CT-1 was significantly positively correlated with total testosterone, hs-CRP and carotid IMT. CT-1 was associated with other cardiovascular risk markers and its use as a cardiovascular risk marker might be suggested. Cardiovascular risk was increased even in lean PCOS patients without MS and it might be associated with elevated androgen levels.

Acute effects of different types of exercises on insulin-like growth factor-1, homocysteine and cortisol levels in veteran athletes

This study aimed to investigate acute effects of table tennis (physical+cognitive exercise), aerobic running (physical exercise), and chess (cognitive exercise) exercise sessions of veteran male athletes in their branches on the serum homocysteine (Hcy), insulin growth factor-1 (IGF-1), and cortisol (Cor) levels. Thirty veteran athletes [10 table tennis players (TT), 10 long-distance runners (LR), 10 chess players (CP)] and 10 sedentary controls (SC) between 50 and 65 years of age participated in the study. Blood samples were obtained before and immediately after exercise to determine serum Hcy, IGF-1, and Cor levels. According to their branch, each veteran athlete performed exercise sessions (70-75% of the participants' heart rate reserve) of 10-min of warm-up followed by 40-min of table tennis, aerobic running, or chess. TT and LR groups demonstrated significant increases in the serum IGF-1, Cor, and Hcy levels from pre to post-exercise (p&lt;0.05). In contrast, the CP group showed significant increases only in the serum Hcy levels (p&lt;0.05). Serum IGF-1 and Hcy, in response to exercise, were not significantly different between exercise groups (p&gt;0.05). LR group had a greater serum Cor increase than all exercise groups (p&lt;0.05). The TT group showed significantly greater changes in serum Cor levels than the CP group (p&lt;0.05). In conclusion, although a single bout of aerobic running and table tennis exercise induces a remarkable increase in all measured biomarkers, chess exercise only elicits an increase in Hcy levels. Although aerobic running is more effective in increasing Cor levels than other types of exercise, the current study's findings suggest that serum Hcy and IGF-1 levels in veteran male athletes are not affected by the type of exercise.

Serum Homocysteine as an Early Diagnostic Marker of Spontaneous Bacterial Peritonitis in Patients with Hepatic Cirrhosis

Serum Homocysteine as an Early Diagnostic Marker of Spontaneous Bacterial Peritonitis in Patients with Hepatic Cirrhosis

Metabolic disorders in hereditary optic neuropathies

To compare the content of folic acid, vitamin B12 and homocysteine in the blood serum of patients with Leber's hereditary optic neuropathy (LHON) and autosomal recessive optic neuropathy (ARON), optic neuropathy of other genesis, and the comparison group. The study involved 58 patients with LHON and ARON, the control group of 49 patients with ischemic, inflammatory, traumatic and compressive optic neuropathies, and the comparison group of 20 healthy volunteers. A decrease in blood folic acid levels was revealed (4.0±1.6 ng/mL) in patients with HON compared to the control group (p=1.3·10-8) and the comparison group (p=1·10-17). The content of vitamin B12 in patients with HON was 380.8±168.1 pg/mL, which was significantly lower than in the comparison group (p=0.0001). The homocysteine content was 14.1±5.6 μmol/L in patients with HON, which was significantly higher than in the control group (p=0.0007) and the comparison group (p=0.000003). At the same time, an increase in homocysteine level of more than 10 µmol/L was revealed in 75% of patients with HON. Similar metabolic disorders were found in groups with various mutations in mitochondrial and nuclear DNA. Patients with HON showed marked decrease in the levels of folic acid and vitamin B12, as well as hyperhomocysteinemia. It is very important to identify the causes of metabolic disorders in order to determine the role of folate deficiency in the development of HON, as well as the possibility of its pharmacological treatment.

Safety and Efficacy of Enalapril Combined with Metoprolol in Patients of Hypertension Complicated with Coronary Heart Disease: A Randomised Clinical Trial

Introduction: Enalapril, which inhibits Angiotensin-Converting Enzyme (ACE), is a commonly used drug for the treatment of hypertension. Metoprolol, a β-blocker, is widely prescribed for patients with cardiac diseases. Essential hypertension has been identified as an independent risk factor of Coronary Heart Disease (CHD). Until now, there are few studies and reports on the application of the two drugs in patients with Hypertension and Coronary Heart Disease (HCHD). Aim: To assess the safety and efficacy of enalapril combined with metoprolol in patients with HCHD. Materials and Methods: The present single-centre randomised clinical trial was conducted on 109 patients with HCHD at Jingdezhen Municipal First People’s Hospital from April 2018 to January 2020. The participants were randomly divided into into two groups, one group on enalapril (n=58), and the other on enalapril and metoprolol combination (n=51). Patients in both groups were treated for eight weeks. The blood pressure, cardiac function index, serum C-Reactive Protein (CRP), Homocysteine (Hcy), and Matrix Metalloproteinase-9 (MMP-9) levels were compared between the two groups, and the adverse drug reactions of the two groups were statistically analysed using independent sample t-test or Mann-Whitney U test. Results: The mean age of enalapril group was 64.78±7.29 years, and the gender ratio was 1:1.42. The mean age of enalapril/ metoprolol combination group was 63.90±6.91 years, and the gender ratio was 1:0.96. After treatment, both systolic and diastolic blood pressure of the enalapril/metoprolol combination group were significantly lower than that of enalapril group (p&lt;0.05). Enalapril combined with metoprolol significantly improved cardiac function and significantly decreased the levels of serum inflammatory markers (CRP 18.57±3.61 vs 27.50±3.60, p&lt;0.001; Hcy 12.14±2.07 vs 13.83±2.17 mmol L-1, p&lt;0.001; MMP-9 372.35±12.34 vs 436.69±13.89 pg L-1, p&lt;0.001; Transforming Growth Factor ALPHA (TGF-a) 8.18±1.38 vs 10.40±1.44 mmol L-1, p&lt;0.001). The overall rate of adverse reactions was not significantly different between the groups (enalapril/metoprolol combination group vs enalapril group, 15.69% vs 10.34%, p=0.406). Conclusion: The combined treatment of enalapril and metoprolol was more effective than enalapril alone in reducing the inflammatory response, reducing blood pressure, and improving cardiac function in patients with HCHD. This combinational therapeutic strategy may be a better choice for patients with HCHD.

Correlation between homocysteine and osteoprotegerin (OPG) serum with bone mineral density in women with systemic lupus erythematosus

Correlation between homocysteine and osteoprotegerin (OPG) serum with bone mineral density in women with systemic lupus erythematosus

Serum homocysteine level as a predictive marker in patients of coronary artery disease - A study of 150 cases

Serum homocysteine level as a predictive marker in patients of coronary artery disease - A study of 150 cases

FABP4 activates the JAK2/STAT2 pathway via Rap1a in the homocysteine-induced macrophage inflammatory response in ApoE−/− mice atherosclerosis

AbstractAtherosclerosis is a chronic inflammatory vascular disease, and inflammation plays a critical role in its formation and progression. Elevated serum homocysteine (Hcy) is an independent risk factor for atherosclerosis. Previous studies have shown that fatty acid binding protein 4 (FABP4) plays an important role in macrophage inflammation and lipid metabolism in atherosclerosis induced by Hcy. However, the underlying molecular mechanism of FABP4 in Hcy-induced macrophage inflammation remains unknown. In this study, we found that FABP4 activated the Janus kinase 2/signal transducer and activator of transcription 2 (JAK2/STAT2) pathway in macrophage inflammation induced by Hcy. Of note, we further observed that ras-related protein Rap-1a (Rap1a) induced the Tyr416 phosphorylation and membrane translocation of non-receptor tyrosine kinase (c-Src) to activate the JAK2/STAT2 pathway. In addition, the suppressor of cytokine signaling 1 (SOCS1)—a transcriptional target of signal transducer and activator of transcription (STATs) inhibited the JAK2/STAT2 pathway and Rap1a expression via a negative feedback loop. In summary, these results demonstrated that FABP4 promotes c-Src phosphorylation and membrane translocation via Rap1a to activate the JAK2/STAT2 pathway, contributing to Hcy-accelerated macrophage inflammation in ApoE−/− mice.

Homocysteine as a Predictor of Hypertensive Disorders of Pregnancy

Homocysteine is an amino acid that is a product of methionine metabolism, it is related to preeclampsia in 20-30%, the increase of this or hyperhomocysteinemia may result from the genetic defect of the enzyme methylenetetrahydrofolate reductase involved in the synthesis of homocysteine. Maternal mortality due to preeclampsia is up to 44% and perinatal mortality is reported at up to 27.8%. The objective of this research was to determine homocysteine levels as a predictor of preeclampsia in pregnant women that have 12 to 20 weeks. This was an observational, longitudinal and prospective investigation. The study population were patients attending the first prenatal care consultation between the 12^th to 20^th weeks, the sample was random and it included 360 patients from whom it was determined their serum homocysteine level. The study excluded 48 patients who did not meet the inclusion and exclusion criteria; it was found homogeneity among the patients, 270 patients (86.5%) had a normal evolution at pregnancy, 27 patients (8.65%) had gestational hypertension, 9 (2.88%) mild preeclampsia and 6 patients (1.9%) severe preeclampsia, none developed HELLP syndrome. Increased homocysteine levels were found in 9 patients who were not related to hypertensive pregnancy disorders. In the present research, homocysteine was not shown to be a predictor of hypertensive disease in pregnancy.

Raised Serum Homocysteine Level is Associated with Coronary Artery Disease in Young Patients

Raised Serum Homocysteine Level is Associated with Coronary Artery Disease in Young Patients

An Unusual Clinical Presentation of Budd–Chiari Syndrome in an Adolescent Boy

AbstractWe report an unusual case of massive splenomegaly with pancytopenia without ascites, which was referred to us with suspicion of a myeloproliferative disorder in an adolescent boy. The work-up done was noncontributory to a hematological disorder. On further work-up, liver biopsy depicted sinusoidal congestion, with Doppler study suggestive of nonvisualization of hepatic veins. There was hypertrophy of the right lobe and the presence of venovenous collaterals. Janus kinase 2 (JAK2) V617F mutation was negative, which confirmed the absence of unidentified myeloproliferative disorder. This was an atypical presentation of Budd–Chiari syndrome (BCS) in children. The absence of ascites could be due to more efficient collateral formation in adolescent age groups due to angiogenesis. Underlying thrombophilia was detected as methylenetetrahydrofolate reductase mutation 677C &gt; T with raised serum homocysteine levels. It is imperative to be aware of the diverse clinical manifestations in children for early detection and appropriate intervention to prevent catastrophic results in pediatric BCS.

The relationship between serum homocystein levels and mortality in vaccinated and unvaccined Covid 19 patients

Introduction: The aim of this study is to evaluate the difference in homocysteine levels between vaccinated and unvaccinated patients and determine the relationship between blood homocysteine levels and prognosis in hospitalized patients due to COVID-19. Methods: This retrospective study was carried out in our hospital on 50 patients, 19 (38%) males and 31 (62%) females, who were hospitalized due to COVID-19. The patients were divided into two groups: vaccinated and unvaccinated. White blood cell count, lymphocyte count, C-reactive protein, D-dimer levels, and homocysteine levels taken at the time of hospitalization of the patients included in the study were evaluated. Results: The mean age of all patients included in the study was 66.1±16.16 years. Of the included patients, 22 (44%) were vaccinated and 28 (56%) were unvaccinated. As a clinical prognosis, 32 patients (64%) were followed up in the ward. Twelve (24%) patients were intubated and discharged after treatment. However, 6 (12%) patients were intubated and unfortunately died. Six of the patients included in the study were mortal. Among these patients, 1 was vaccinated and 5 were not vaccinated. The mean D-dimer level of these patients was 965.16±544.39. All expired patients were hyperhomocysteinemic, and the mean homocysteine levels were 18.18±5.8 μmol/L in this group. Discussion and Conclusion: Although D-dimer was found to be significantly higher at the time of admission to the hospital in unvaccinated individuals, there was no significant difference in blood homocysteine levels between vaccinated and unvaccinated COVID-19 patients.

A rare case of bilateral superior ophthalmic vein thrombosis presenting simultaneously with central retinal vein occlusion and cerebral venous sinus thrombosis

A 57-year-old female presented with redness in both eyes and headache for 1-month duration. The clinical examination showed bilateral episcleral vessels congestion and central retinal vein occlusion. Optical coherence tomography scans were normal in both eyes. Radiological examination revealed bilateral superior ophthalmic vein thrombosis and venous sinus thrombosis involving the left terminal sigmoid sinus. The serum homocysteine level was elevated. The patient was treated with anticoagulants and vitamin B12 supplements. Three months following the initial presentation, there was a reduction in the episcleral vessel congestion and retinal hemorrhages. The magnetic resonance venography at the end of 3 months showed a partially recanalized left jugular bulb with chronic thrombosis of the left terminal sigmoid sinus.

Role of hyperhomocysteinemia and Vitamin B12 deficiency in central and hemi-central retinal vein occlusion: A case-control study.

BACKGROUND:Retinal venous occlusive diseases have been recognized as a major cause of ocular morbidity. Hyperhomocysteinemia could be a potentially modifiable risk factor.OBJECTIVE:To determine the association of hyperhomocysteinemia with central and hemi-central retinal vein occlusion (CRVO and HCRVO), the correlation of serum levels of homocysteine with Vitamin B12 and folate levels and the association of Vitamin B12 deficiency with hyperhomocysteinemia.METHODS:In this case–control study, patients with CRVO and HCRVO, and age- and gender-matched controls without CRVO and HCRVO, who met the eligibility criteria, were enrolled after obtaining informed consent. Data obtained from participants using a questionnaire, complete ophthalmological examination and relevant investigations, including estimation of serum homocysteine, Vitamin B12 and folate levels, were collated and analyzed.RESULTS:Thirty-nine cases with CRVO and HCRVO and 39 age- and gender-matched controls were studied. We found a significant association of hypertension (P < 0.01), hyperlipidemia (P = 0.01), and abnormal blood profile (P < 0.01) with retinal vein occlusion. There was no statistically significant association of hyperhomocysteinemia with CRVO and HCRVO (P = 0.81). However, we found a high prevalence of both hyperhomocysteinemia (43.58% of cases and 53.84% of controls; P = 0.81) and Vitamin B12 deficiency (23.08% of cases and 38.46% of controls; P = 0.14) in cases and controls, without a statistically significant difference between the two groups with respect to both parameters. Our study also found a negative correlation of serum levels of homocysteine with Vitamin B12 (Pearson correlation co-efficient − 0.3874, P = 0.0005), and folate (Pearson correlation coefficient − 0.3886, P = 0.0004) of the study participants. Among the study participants (n = 78), the odds of patients with Vitamin B12 deficiency having hyperhomocysteinemia were 7.0 (2.26–21.72) times those of patients without Vitamin B12 deficiency (P = 0.001). Similarly, among the cases (CRVO, n = 39), the odds of patients with Vitamin B12 deficiency having hyperhomocysteinemia were 7.0 (1.22–40.09) times those of patients without Vitamin B12 deficiency (P = 0.029). In the control group also (non-CRVO, n = 39), the odds of patients with Vitamin B12 deficiency having hyperhomocysteinemia were 6.67 (1.47–30.21) times those of patients without Vitamin B12 deficiency (P = 0.014).CONCLUSION:Hyperhomocysteinemia was not found to be an independent risk factor for retinal vein occlusion in our study. However, we found a high prevalence of hyperhomocysteinemia and Vitamin B12 deficiency in both cases and controls, without a statistically significant difference between the two groups with respect to both parameters. We also found a negative correlation of serum homocysteine levels with Vitamin B12 and folate levels. The odds of patients with Vitamin B12 deficiency having hyperhomocysteinemia were seven times those of patients without Vitamin B12 deficiency. Hypertension, hyperlipidemia, and abnormal blood profile had a significant association with CRVO and HCRVO. Many of the systemic risk factors for retinal vein occlusions are found to be associated with elevation of serum homocysteine levels, which may be part of a final common pathway in bringing about a state of accelerated atherosclerosis, leading to CRVO or HCRVO. Therefore, lowering serum levels of homocysteine by Vitamin B12 and folate supplementation could have a role in the prevention of these diseases.

Intravenous thrombolysis with alteplase in the treatment of acute cerebral infarction.

Objectives:To compare the efficacy and safety of intravenous thrombolysis with alteplase and intravenous thrombolysis with urokinase for patients with acute cerebral infarction.Methods:This prospective study included 140 patients with acute cerebral infarction who were admitted to our hospital between June 2018 and June 2019. They were randomly divided into two groups. The control group (70 cases) was treated with urokinase intravenous thrombolysis, and the observation group (70 cases) was given alteplase intravenous thrombolytic therapy. The treatment efficacy and safety of the two groups were compared.Results:The total effective rate of the observation group was 95.7%, and that of the control group was 78.6%, i.e., the total effective rate of the observation group was significantly superior to the that of the control group (P < 0.05). After treatment, the observation group had significantly lower National Institutes of Health Stroke Scale (NIHSS) score and significantly higher mini-mental state examination (MMSE) score than the control group; the difference was statistically significant (P<0.05). After treatment, the levels of inflammatory factors of both groups significantly decreased compared to before treatment, and the decrease in the observation group was larger than that in the control group (P<0.05). The levels of serum homocysteine (Hcy) and monocyte chemoattractant protein-1 (MCP-1) in the observation group were significantly lower than those in the control group after treatment, and the differences were statistically significant (P<0.05). The incidence of hemorrhagic adverse reaction in the observation group was lower than that in the control group (P<0.05).Conclusion:In the treatment of acute cerebral infarction, ccompared with urokinase, alteplase can further relieve cognitive impairment and promote the recovery of nerve function through inhibiting levels of inflammatory factors and levels of serum Hcy and MCP-1.