ObjectiveTo observe the changes of serum homocysteine acid ( Hcy),interleukin-6 (IL-6) and high sensitive C-reactive protein (hs-CRP)and elucidate the clinical significance in patients with acute stroke. MethodsA total of 126 acute stroke patients were enrolled in the investigation. Based on the MESS,patients were divided into different groups according the severity and prognosis, and 108 physically healthy subjects were selected as controls. The concentration of serum Hcy, IL-6, and hs-CRP were determined in all cases after being attacked at day 3,day 14 and day 28 respectively. Results①The levels of Hcy, IL-6, hs-CRP in patients with acute stroke were significantly higher than controls ( (58.24 ±9.86) μmol/L vs. ( 17.12 ±4.23) μ mol/L, (59.64 ±13.82) ng/L vs. (18.46 ±4.62) ng/L,(19.78 ±6.12) mg/L vs. (2.28 ±0.82) mg/L,all P＜0. 01 ). ②The levels of Hcy,IL-6, hs-CRP in patients with mild, moderate and severe acute stroke were significantly higher than controls (P ＜ 0.01 ) at 3 day after the onset; and the Hcy, IL-6, hs-CRP were also significantly lower in mild cases with acute stroke compared with moderate and severe cases (P ＜ 0. 01 ). At day 14 ,the moderate and severe patients had significantly higher levels of Hcy, IL-6, hs-CRP than mild cases and controls (P ＜ 0.01 ). At day 28 the severe patients had significantly higher levels of Hcy, IL-6, hs-CRP than mild and moderate cases and controls (P ＜ 0.01 ) ③At day 28, the levels of Hcy, IL-6, hs-CRP in basically recovered and remarkably improved cases were significantly lower than unrecovered cases [ ( 16.12 ± 4.74) μmol/L, ( 1 8.42 ± 5.02) μ mol/L vs. ( 48.69 ± 7.89)μmol/L; ( 19.52 ± 5.67 ) ng/L, ( 20. 74 ± 6. 13 ) ng/L vs. ( 51.26 ± 11.66 ) ng/L, ( 3.21 ± 1.36) mg/L,(3.24 ± 2.51 ) mg/L vs. ( 8.86 ± 1.32 ) mg/L respectively, all P ＜ 0. 01 ]. ConclusionsThe levels of serum Hcy, IL-6, hs-CRP are significant biomarkers to evaluate the severity and prognosis of acute stroke.