牛磺酸治疗高同型半胱氨酸脑梗死患者动脉粥样硬化的临床观察

Effect of taurine on atherosclerosis in patients with cerebral infarction induced by hyperhomocysteinemia

目的探讨牛磺酸对高同型半胱氨酸脑梗死患者动脉粥样硬化的治疗作用。方法选择自2006年9月至2006年12月哈尔滨医科大学附属第一医院神经内科住院的40例高同型半胱氨酸脑梗死患者，按随机数字表法分为牛磺酸治疗组和叶酸、维生素治疗组，相应的药物治疗6个月。治疗前后分别检查颈动脉彩超，观察颈动脉内膜中层厚度（IMT）和斑块变化情况，采血分离血清，采用高压液相色谱分析仪及相应试剂盒测定血浆同型半胱氨酸水平。结果经治疗6个月后，叶酸、维生素组颈动脉IMT平均厚度减小0．372mm，牛磺酸治疗组减小0．551mm．两组在治疗前后颈动脉IMT比较差异均有统计学意义（P〈0．05），且牛磺酸治疗组对颈动脉IMT的控制要优于叶酸、维生素治疗组．差异有统计学意义（P〈0．05）。牛磺酸治疗组治疗前后血浆同型半胱氨酸水平[（29．832±7．750）μmol／LVS（19．316±2．240）μmol／L]比较差异有统计学意义（P〈0．05）。结论牛磺酸对高同型半胱氨酸脑梗死患者动脉粥样硬化的治疗有效且优于叶酸、维生素，并对血浆同型半胱氨酸水平有控制作用。

Objective To investigate the therapeutic effect of taurine on atherosclerosis in patients with hyperhomocysteinemia （Hhcy）-induced cerebral infarction （CI）. Methods Forty patients with CI induced by Hhcy were randomized into two equal groups to receive taurine injections or folacin plus vitamin B12 treatment for 6 months. Color Doppler ultrasound was performed to examine the intima-media thickness （IMT） and the plaques in the carotid artery before and after the treatment. Blood samples were obtained from the patients to determine the changes in plasma homocysteic acid （Hcy） level using high-pressure liquid chromatography. Results Both taurine injections and folacin plus vitamin B12 treatment for 6 months resulted in a significant reduction in the IMT of the carotid artery （P〈0.05）, but taurine caused a significantly greater reduction （0.551 mm vs 0.372 mm, P〈0.05）. Taurine also showed a better effect than folacin plus vitamin B12 in decreasing the number of atherosclerotic plaques （P〈0.05）. Taurine treatment significantly decreased the plasma Hey level as compared with the level before treatment （19.316±2.240 μmol/L vs 29.832±7.750 μmol/L, P〈0.05）. Conclusions Taurine has better therapeutic effect than folacin plus vitamine B12 on atherosclerosis and helps control plasma Hcy level in patients with Hhcy-induced CI.