急性脑梗死患者血浆同型半胱氨酸水平及其干预治疗探讨

Study on Plasma Homocysteine(Hcy)Levels in Patients with Acute Cerebral Infarction and the Effect of Intervention Treatment

目的探讨急性脑梗死患者给予维生素B12制剂(甲钴胺)和叶酸(Fa)治疗前后血浆同型半胱氨酸(Hcy)、叶酸和维生素B12水平变化及其对预后的影响。方法检测152例急性脑梗死患者和132例正常人血浆同型半胱氨酸(Hcy)、叶酸、维生素B12水平,并对急性脑梗死患者进行神经功能缺损评分(NIHSS);将急性脑梗死组随机分为干预组和非干预组,干预组给予维生素B12制剂(甲钴胺)联合叶酸治疗,治疗4周后复测血浆同型半胱氨酸(Hcy)、叶酸和维生素B12水平,并再次进行神经功能缺损评分(NIHSS)。结果急性脑梗死组和正常健康对照组之间血浆Hcy水平、叶酸和维生素B12水平存在明显差异(P<0.01),予以补充叶酸和维生素B12(甲钴胺)治疗后,干预组血浆Hcy水平明显下降,神经功能缺损评分显著升高,与非干预组相比有显著性差异(P<0.05)。结论急性脑梗死患者血浆Hcy水平升高,补充叶酸、维生素B12制剂有助于降低血浆Hcy水平,有利于脑梗死疾病的转归。

Objective To explore the changes of the levels of plasma homocysteine（ Hcy）, folate and vitamin B12 and the relationship between the changes and the prognosis in patients with acute cerebral infarction who were treated with vitamin B12 preparation （methylcobalamin） and folate. Methods The plasma level of Hey, folate and vitamin B12 （ VitB12 ） of 152 patients with cerebral infarction and 132 healthy people were measured,and the patients with acute cerebral infarction were given a mark with the evaluation of neurological impairments （NIHSS）. The patients with acute cerebral infarction were randomly divided into intervention group and non-intervention group. The intervention group was treated with vitamin B12 preparations （methylcobalamin） and folate. After 4 weeks, retested the plasma homocysteine （Hcy）, folate and vitamin B12 levels, and carried out NIHSS score once again. Results In the plasma level of Hcy, folate and vitamin B12 , there were significant differences between the acute cerebral infarction group and the healthy control group （P 〈 0.01 ）. In intervention group, the plasma homocysteine levels decreased significantly, and the evaluation scores increased significantly after intervention treatment, and there was significant differences between intervention group and non-intervention group （P 〈 0.05）. Conclusion The levels of plasma Hcy increased in the patients with acute cerebral infarction. Being added with folate and vitamin B12 preparations was well to reduce the levels of plasma Hey,and it was also conducived to the prognosis of acute cerebral infarction.