Abstract：Objective: To explore the correlation between homocysteine (Hcy) level and cognitive dysfunction and disease progression in patients with small cerebral vascular disease (CSVD). Methods: A total of 78 cases of CSVD patients diagnosed and treated in our hospital from December 2016 to December 2018 were retrospectively selected as the study objects. With the Montreal cognitive assessment scale (MoCA) score, they were divided into the cognitively normal group (32 cases) and the cognitively impaired group (46 cases), and another 52 cases of healthy physical examination patients were selected as the healthy control group. The differences in clinical data and Hcy level among the three groups were compared, and the correlation between Hcy level and cognitive dysfunction and disease progression was analyzed. Results: The control group of Hcy level was (10.12±3.45) umol/L, the cognitive normal group was (18.18±3.86) umol/L, and the cognitive impairment group was (23.35±4.42) umol/L, with statistically significant differences (P<0.05). MoCA score of cognitive normal group was higher than that of cognitive impairment group, and the difference was statistically significant (P<0.05). Pearson correlation showed that Hcy level was negatively correlated with MoCA total score, visual spatial executive function, memory and attention, abstract thinking, and directional force (r=-0.438, -0.264, -0.239, -0.333, P<0.05), but not with naming, language, and delayed recall (r=-0.005, -0.001, -0.083, P>, 0.05).After a one-year follow-up, 62.82% (49/78) in the CSVD progression group and 37.18% (29/78) in the non-progression group, and Pearson correlation showed that Hcy level was significantly negatively correlated with imaging outcome scores of CSVD patients (r=-0.351,P<0.01).According to ROC curve analysis, the AUC of Hcy in predicting the course of CSVD was 0.938, the sensitivity and specificity were 87.8% and 93.1%, respectively, showing high accuracy. Conclusion: The increased level of Hcy can be involved in the cognitive impairment of CSVD, and is negatively correlated with the progression of CSVD.
2020, Vol. 26 
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