Objective  To explore the relationships of the National Institutes of Health Stroke Scale (NIHSS) score and plasma homocysteine (Hcy) level with acute cerebral infarction (ACI), and related risk factors.

  Methods  One hundred patients with ACI were selected as observation group. According to the Chinese Ischemic Stroke Subclassification (CISS), the patients were divided into large artery atherosclerosis (LAA) group, perforating artery disease (PAD) group, cardiogenic stroke (CS) group, other etiologies (OE) group, and undetermined etiology (UE) group. Meanwhile, a total of 50 healthy individuals with physical examinations were selected as control group. Plasma Hcy was measured, the patients' NIHSS scores at admission were evaluated, and risk factors of ACI were analyzed.

  Results  The CS group had significantly higher NIHSS score than the PAD group, and significantly lower Hcy level than the LAA group (P < 0.05). The NIHSS score was positively correlated with plasma Hcy level in patients with ACI (r=0.226, P=0.024). There were statistically significant differences between the observation group and the control group in terms of smoking history, hypertension, triglyceride (TG), high-sensitivity C-reactive protein (hs-CRP), and Hcy levels (P < 0.05). Smoking history, hypertension, high TG, high hs-CRP, and high Hcy were independent risk factors for ACI (P < 0.05).

  Conclusion  Patients with CS have higher NIHSS scores among ACI patients, and those with LAA have the highest plasma Hcy levels. Smoking history, hypertension, high TG, high hs-CRP, and high Hcy are risk factors for ACI, and Hcy is closely related to the severity of ACI.