叶酸和维生素B_6、甲钴铵联合治疗伴有高同型半胱氨酸血症青年脑卒中患者100例疗效观察

Combination of folic acid,vitamin B6 and methylcobalamin in the treatment of young patients with ischemic stroke accompanied with hyperhomocysteinimia

目的观察叶酸、维生素B6和甲钴铵联合治疗合并高同型半胱氨酸(Hcy)血症的青年脑卒中的疗效。方法将200例青年脑卒中合并高同型半胱氨酸(Hcy)血症的患者随机分为叶酸和维生素B6、甲钴铵治疗组和对照组,每组各100例。治疗组给予叶酸5mgqd、维生素B610mgqd、甲钴铵500μgqd,连续用药4周,对照组不予叶酸和维生素B6、甲钴铵。治疗前后检查血浆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周后治疗组Hcy浓度明显下降,两组治疗在降低血Hcy浓度方面比较差异有统计学意义(P<0.01),但两组神经功能康复差异无统计学意义(P>0.05),两组治疗过程中均未出现不良反应。结论叶酸和维生素B6、甲钴铵联合治疗青年脑卒中合并高同型半胱氨酸血症有明显疗效,无不良反应,但对神经功能康复无明显的疗效。

Objective To explore the effects of the combination of folic acid, vitamin B6 and methylcobalamin in the treatment of young patients with ischemic stroke accompanied with hyperhomocysteinimia. Methods 200 young ischemic stroke patients accompanied with hyperhomocysteinimia were randomly divided into two groups： the combined treatment group（ 100 cases） were given folic acid oraUy（5mg/d）, vitamin B6 （ 10 mg/d） and methylcobalamin（500μg/d） in addition to routine treatment, while the other group（ 100 cases） were routinely treated as control. The blood samples of the two groups were assayed pre- and post- treatment（four- week later） and the concentration of Hcy were measured and analyzed separately. Results Comparing with those patients routinely treated, a great decrease in the Hcy concentration was observed in those received combined treatments （P 〈 0.01 ）, while no significant differences were found in the recovery of neural functions. And no adverse reactions occurred during our research. Conclusion Combined therapy of folic acid, vitamin B6 and methylcobalamin can obviously decrease the serum Hcy concentration and improve the condition of the young ischemic stroke patients with hyperhomocysteinimia, while rarely effect on the recovery of neural functions.