青年缺血性脑卒中患者血同型半胱氨酸、叶酸和维生素B12水平变化及其干预效果观察

Change level of serum homocysteine, folic acid and vitamin B12 levels in young patients with ischemic stroke and the effect of the intervention

目的探讨青年缺血性脑卒中患者血同型半胱氨酸（Hcy）、叶酸和维生素B12水平变化及其应用维生素B6、维生素B12和叶酸治疗后的水平变化。方法选取我院2003年1月至2013年12月住院的青年缺血性脑卒中患者120例作为病例组（干预组60例和非干预组60例），同时选取我院同期年龄相同的无神经系统疾病青年体检者120名作为对照组。检测研究者的血浆Hcy、叶酸、维生素B12浓度。非干预组给予基础治疗，干预组在此基础上给予维生素B6、维生素B12和叶酸治疗。治疗4周后复测血浆Hcy、叶酸和维生素B12水平。结果与对照组血浆Hey水平（10．2±3．1）μmmol／L比较，病例组（21．3±4．5）μmmol／L明显升高（t=22．3，P〈0．05）；干预组与非干预组之间血浆Hcy、叶酸和维生素B12水平差异无统计学意义（P均〉0．05）。治疗后干预组血浆Hey水平（10．5±3．0）μmmol／L明显下降，叶酸（6．5±2．8）μg/L和维生素B12水平（450．2±155．6）ng／L）升高（P均〈0．05）。结论青年缺血性脑卒中患者血浆Hcy水平升高，通过补充维生素B6、维生素B12和叶酸可降低血浆Hcy水平，有利于青年缺血性脑卒中的转归。

Objective To explore the variations and prognostic factors of hyperhomocysteinaemia in ischemic cerebral apoplexy for the youth who administrated vitamin B6, vitamin B12 and folic acid at pretherapy and post-treatment. Methods One hundred and twenty cases of young patients with ischemic cerebral apoplexy in the Pinggu Hospital of Capital University from January 2003 to December 2013 as case group （intervention group,60 cases and 60 cases of non-intervention group）, while 120 youth volunteers with the same period and age without neurological diseases as a control group. Both groups patients were detected for hyperhomocysteinaemia, folic acid and vitamin B12. The non-intervention group was administrated basic treatment,while the intervention group administrated vitamin B6, vitamin B12 and folic acid on this basis. The hyperhomocysteinaemia, folic acid and vitamin Bl2 were detected repetitively after four weeks. Results Compared with control group, the hyperhomocysteinaemia in ischemic cerebral apoplexy group for the youth had increased significantly （（ 10.2 ± 3.1） μmmol/L vs. （21.3 ± 4.5） μmmol/L, P 〈 0.05） .The hyperhomocysteinaemia,folic acid and vitamin Bn had no significant differences between intervention group and non-intervention group （P 〉 0.05）.After replenished vitamin B6, vitamin B12 and folic acid, the hyperhomocysteinaemia had decreased significantly （ （10. 5 ± 3.0） μmmol/L） in intervention group. Folic acid （ （6. 5±2. 8）μg/L） and vitamin B12（450. 2± 155.6） ng/L） had increased significantly（ P〈0. 05）. Conclusion The hyperhomocysteinaemia increased in ischemic cerebral apoplexy for the youth. It is that hyperhomocysteinaemia decreased by replenished vitamin B6, vitamin B12 and folic acid which make for prognosis in isehemie cerebral aDoolexv for the youth.