叶酸治疗短暂性脑缺血发作伴高半胱氨酸血症疗效观察

The therapeutic effect of folic acid on transient ischemic attack patients with homocysteinaemia

目的观察叶酸治疗对合并高半胱氨酸血症（Hcy）的短暂性脑缺血发作（TIA）患者血浆高半胱氨酸（HCA）水平及预后的影响。方法将129例合并Hey的TIA患者应用随机数字法随机分为2组，对照组（n=64）只给予常规治疗，观察组（n=65）在常规治疗的基础上给予叶酸治疗．对比分析2组患者治疗前及治疗后3个月HCA水平的变化及其1年内完全缓解率及完全性脑卒中发生率。结果初发TIA患者Hey的发生率高达41．4％。治疗3个月后，观察组血浆HCA显著降低[（14．27±6．13）μmol／L，（24．99±6．87）μmol／L，t=2．799，P〈0．01]，而对照组血浆HCA无明显变化[（24．68±6．89）μmol／L，（25．68±7．11）μmo]／L，t=2．735，P〈0．01]。1年后，观察组完全性脑卒中发生率显著低于对照组（9．8％，25．0％，χ^2=4．849，P〈0．05），TIA症状完全缓解率高于对照组（73．8％，50．0％，χ^2=7．253，P〈0．01）．且无明显不良反应。结论叶酸治疗可有效降低TIA患者的血浆HCA水平，改善患者的预后。

Objective To observe the therapeutic effect of folic acid on transient ischemic attack （TIA） patients with homocysteinaemla（Hcy）. Methods 129 patients of primary TIA with Hcy were divided into two groups randomly. The obsen, ation group （ n = 65 ）was administered with conventional therapy and folic acid, and the control group （ n = 64 ） was only given conventional therapy. The variances of the plasma HCA level three months later were compared,and remission rate of TIA and complete stroke incidence one year later were analyzed between two groups. Results The Hcy incidence rate of TIA patients was up to 41.4%. Three months later,the plasma HCA level of observation group was lower than control group（ （ 14.27 ±6.13） μmol/L vs （24.99 ±6.87） μmol/L, t = 2. 799, P 〈 0.01 ）, and much lower than that of the control group post-treatment （ （ 14.27 ± 6.13 ）μmol/L vs （24.68 ± 6.89）μmol/L, t = 2. 735, P 〈 0.01 ）. One year later, the complete stroke incidence of TIA in observation group was lower than that of the control group（9.8% vs 25.0% , P〈 0.05 ） , and complete remission rate was higher than the latter（73.8% vs 50.0%, P 〈 0.01）. Conelusion Folic acid can decrease the plasma HCA level of TIA patients with Hcy efficiently,and improve the prognosis of such patients.