叶酸和维生素B_6、B_(12)联合治疗青年脑卒中合并高同型半胱氨酸血症的疗效观察

Curative effects observation of the combined therapy of Folic acid,Vitamin B_6 and B_(12) in youth stroke associated with hyperhomocysteinemia

目的观察叶酸和维生素B6、B12联合治疗青年脑卒中合并高同型半胱氨酸(Hcy)血症的疗效。方法将150例青年脑卒中合并高Hcy血症患者随机分为低剂量叶酸和维生素B6、B12治疗组(低剂量组)、高剂量叶酸和维生素B6、B12治疗组(高剂量组)、对照组,每组50例。用药剂量:低剂量组给予叶酸2.5mg/d、维生素B610mg/d、维生素B120.5mg/d,高剂量组给予叶酸5mg/d、维生素B630mg/d、维生素B121.5mg/d,连续给药4周,对照组不予叶酸和维生素B6、B12治疗。治疗前后检测血浆Hcy浓度,治疗后血浆Hcy浓度<15μmol/L为有效;并观察不良反应。结果治疗4周后低剂量组、高剂量组临床有效率分别是70.4%、71.6%,与对照组(4.6%)相比差异有统计学意义(均P<0.01);治疗后低剂量组、高剂量组血浆Hcy浓度比治疗前明显降低(下降33.9%和36.1%)(均P<0.01);对照组治疗后的血浆Hcy浓度无明显下降。3组治疗过程中均未出现不良反应。结论叶酸和维生素B6、B12联合治疗青年脑卒中合并的高Hcy血症有明显效果,而且高、低两种剂量均有效;无不良反应。

Objective To observe the curative effects of the combined therapy of Folic acid, Vitamin（Vit） B6 and Vit B12 in youth stroke associated with hyperhomocysteinemia. Methods 150 youth stroke patients with hyperhomocysteinemia were randomly devided into low dose Folic acid, Vit B6 and Vit B12 treatment group（ low dose group） ; high dose Folic acid,Vit B6 and Vit B12 treatment group（ high dose group） and control group, 50 cases in each group. Low dose group was taken by the treatments of Folic acid 2.5 mg/d, Vit B6 10 mg/d, Vit B12 0.5 mg/ d; high dose group was taken by the treatments of Folic acid 5 mg/d, Vit B6 30 mg/d, Vit B12 1.5 mg/d; control group was not taken by the treatments of Folic acid, Vit B6 and Vit B12. The plasma homocysteine （Hey） concentration was detected before and after treatment. The level of plasma Hey 〈 15 μmol/L was evaluated as effective. Moreover, side effect was also observed. Results After the 4 weeks treatment, the effective rates were 70.4% and 71.6% in low and high dose groups respectively, and there were significant differences compared with control group （4.6% ,all P 〈0. 01 ）. The level of plasma Hey obviously decreased in low dose and high dose groups （ 33.9% and 36.1% respectively, all P 〈0.01 ） than before treatment. In the control group, the decreasing of plasma Hey concentration was not obvious after treatment （ P 〉 0. 05 ）. No obvious side effect was found in the three groups. Conclusions It is effective in the combined therapy of Folic acid, Vit B6 and Vit B12 in youth stroke associated with hyperhomocysteinemia. The effectiv rates are same by the low dose and high dose drug. The therapy is free from side effect.