Association between homocysteine level and neurological functional recovery in patients with acute ischemic stroke treated by intravenous thrombolysis using alteplase
Huang Hui
Wu Di
Sun Hui
Qian Wei-dong
Abstract：Objective To explore the correlation between neurological recovery and homocysteine(Hcy)levels in acute ischemic stroke(AIS)patients undergoing intravenous thrombolysis with alteplase(rt-PA).Methods A total of 100 AIS patients receiving rt-PA intravenous thrombolysis in the First Affiliated Hospital of Bengbu Medical College between January 2021 and July 2022 were included in this study.The patients were divided into a normal level group(Hcy level<15.0 μmol·L-1,n=43)and a high level group(Hcy level≥15.0 μmol·L-1,n=57)according to their Hcy levels at admission.After treatment for three months,the Na-tional Institutes of Health Stroke Scale(NIHSS)and Modified Rankin Scale(mRS)scores of the two groups were compared,and the association of Hcy levels and NIHSS and mRS scores was analyzed using the Pearson coefficient.Results There were statistically significant differences in folic acid and vitamin B12 levels between the two groups(t=8.508,10.315,both P<0.05).Before treatment,the NIHSS scores did not differ significantly between the two groups(P>0.05).Compared with those before treatment,NIHSS scores decreased at 12 hours after treatment,at discharge,and at 3 months after onset in both groups,and they were lower in the normal level group((11.35±2.41)points,(7.70±1.82)points,(5.63±1.43)points)than in the high level group((14.79±2.27)points,(11.05±2.42)points,(8.93±2.35)points)(t=7.306,7.597,8.136,all P<0.05).Before treatment,no significant difference in mRS score was observed in both groups(P>0.05).Compared with the high-level group,the normal-level group accounted for more patients with mRS score≤2 points 3 months after onset,and the difference was statistically significant(χ2=5.017,P=0.025).Hcy levels were positively correlated with NIHSS scores(r2=0.516,P<0.001)and mRS scores(r2=0.603,P<0.001).Conclusion In acute ischemic stroke patients with Hcy levels≥15.0 μmol·L-1,the neurological prognosis is poorer and requires attention after intravenous thrombolysis with alteplase.
Keywords：Acute ischemic strokeHomocysteineAlteplaseIntravenous thrombolysisNeurological functional recoveryCorrelation analysisPrognosis
Publication Date：2025-02-24
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 1-4 )