叶酸和维生素B_(12)对伴有高同型半胱氨酸血症脑梗死患者炎症因子的干预研究

Research on the invention of acidum folicum and Vitamin B_(12) to inflammatory factors in cerebral infarction patients with hyperhomocysteinemia

目的观察叶酸和维生素B12(VitB12)治疗对伴有高同型半胱氨酸血症(HHcy)的脑梗死患者血清高敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)、基质金属蛋白酶-9(MMP-9)的影响。方法将112例HHcy脑梗死患者与同期健康体检者做血清hs-CRP、TNF-α、IL-8、MMP-9做比较。采用随机分组,将112例HHcy患者分为干预组和常规治疗组,每组各56例,常规治疗组给予抗血小板、改善脑供血等常规治疗,干预组在常规治疗基础上,加用叶酸5 mg口服,qd,VitB120.5 mg口服,qd,在治疗前及治疗8周后做血清总同型半胱氨酸(t-Hcy)、hs-CRP、TNF-α、IL-8、MMP-9检测并比较。结果 HHcy的脑梗死患者血清hs-CRP、TNF-α、IL-8、MMP-9水平高于对照组,干预组在治疗8周后血清t-Hcy、hs-CRP、TNF-α、IL-8、MMP-9较常规治疗组降低(P<0.05)。结论叶酸和VitB12治疗在降低t-Hcy的同时可以降低血清hs-CRP、TNF-α、IL-8、MMP-9,HHcy致脑梗死的作用机制可能与炎性应激反应有关,而叶酸和VitB12能减轻这一反应。

Objective To observe the therapies of acidum folicum and Vitamin B12 to serum high sensitivity C reactive protein （hs-CRP）, tumor necrosis factor α （TNF-α）, interleukin-8 （IL-8）, matrix metalloproteinase-9 （MMP-9） in cerebral infarction patients with hyperhomocysteinemia （HHcy）. Methods Serum hs-CRP, TNF-α, IL-8 and MMP-9 level from 112 cerebral infarction patients with HHcy and health physical examinees at the same time were measured. 112 cerebral infarction patients were randomly divided into the invention group with acidum folicum and Vitamin B12 and the conventional therapy group, each group had 56 patients. The conventional therapy group was given treatments with antiplatelet and improving cerebral blood supply, the invention group was given acidum folieum 5 mg three times a day and Vitamin B12 0.5 mg three times a day based on the convention therapy. Serum total homocysteine （t-Hcy）, hs-CRP, TNF-α, IL-8 and MMP-9 level were measured before and after 8 weeks＇therapy respectively and were compared. Results The levels of serum hs-CRP, TNF-α, IL-8 and MMP-9 in the cerebral infarction patients with HHcy were higher than those in the health control examinees. After 8 weeks＇treatment, the levels of serum t-Hcy, hs- CRP, TNF-α, IL-8 and MMP-9 in the invention group were lower than those in the conventional therapy group （P 〈 0.05）. Conclusion Acidum folicum and Vitamin B12 can reduce the levels of serum hs-CRP, TNF-α, IL-8 and MMP-9 in the cerebral infarction patients with HHcy beside reducing t-Hcy level. The mechanism of HHcy for cerebral in- farction may be associated with inflammatory stress response which can be alleviated by acidum folicum and Vitamin Hi2.