甲钴胺对H型高血压脑梗死患者预后影响观察

Effect of methylcobalamin treatment on prognosis of patients with hyperhomocysteinima-related hypertention combined with cerebral infarction

目的观察甲钴铵对H型高血压脑梗死患者预后影响及血中同型半胱氨酸(Hcy)水平的变化情况。方法选取在江苏省泰兴市人民医院神经内科住院的56例H型高血压急性脑梗死患者,分为干预组和常规组,均给予常规脑梗死治疗,干预组在常规治疗基础之上给予甲钴胺1 mg,每天静脉注射,连用8周。分别在住院第2天、治疗4、8周后检测两组患者血浆Hcy水平,并采用美国国立卫生院卒中量表(NIHSS)和日常生活Barthel指数(BI)评价患者神经功能缺损程度及日常生活能力。结果治疗8周后,干预组血浆Hcy水平[(16.6±6.6)μmol/L]较常规组[(25.8±9.5)μmol/L]明显降低(P<0.01)。干预组NIHSS评分[(18±5)分]明显低于常规组[(21±6)分],BI评分[(83±19)分]高于常规组[(69±22)分](P<0.05)。结论甲钴胺治疗可降低血浆Hcy水平,改善急性脑梗死患者预后。

Objective To observe the effect of methylcobalamin（MeCbl） treatment on blood serum homocysteine（Hcy） level and prognosis of patients with hyperhomocysteinima-related hypertention combined with cerebral infarction. Methods 56 patients with hyperhomocysteinima-related hypertention combined with acute cerebral infarction were divided into intervertion treatment group and routine treatment group.The two groups were all given conventional cerebral infarction treatment,intervertion treatment group was additionally given 1mg intervertion intravenously for 8 weeks.The blood serum Hcy levels of the two groups were detected respectively on the 2nd day,4th and 8th weeks after treatment.NIH stroke scale（NIHSS） and barthel index（BI） were used to assess neurological function and personal activities of daily living.Results After 8 weeks of treatment,the blood serum Hcy level [（16.6 ±6.6） μmol/L vs（25.8± 9.5） μmol/L]（P 0.01） and NIHSS [（18±5） scores vs（21±6） scores] of the intervertion treatment group were lower significantly than those of the routine treatment group（P 0.05）.The BI of intervertion treatment group [（83 ±19） scores] was higher than that of the routine treatment group [（69±22） scores].Conclusion MeCbl treatment can reduce the blood serum Hcy level and improve the prognosis of patients with hyperhomocysteinima-related hypertention combined with acute cerebral infarction.