叶酸联合维生素B12对慢性心力衰竭患者血清同型半胱氨酸、N端脑钠肽水平及左心功能的影响

Effects of Folic Acid Combined Vitamin B12 on Plasma Level of Homocysteine and Left Ventricular Function in Patients with Chronic Heart Failure

目的观察叶酸联合维生素B12(Vitamin B12)对慢性心力衰竭(chronic heart fa-ilure,CHF)患者血清同型半胱氨酸(Homocysteine,Hcy)及B型脑钠肽前体N端片段(N-terminal brain natriuretic peptide,NT-pro BNP)水平及左心功能的影响。方法将符合入选标准120例CHF患者,按入选顺序随机分为治疗组58例和对照组62例,两组均予CHF常规治疗,治疗组在常规治疗基础上加用叶酸5 mg(1次/d)及维生素B12 0.5 mg(1次/d),疗程均为6个月;比较治疗前后血清Hcy及NT-pro BNP水平,左室舒张末期内径(LVEDD)、左室射血分数(LVEF)、左室舒张早期心室充盈峰值(E峰)与舒张晚期心室充盈峰值(A峰)比值的变化。结果治疗后两组Hcy、NT-pro BNP均明显下降(P≤0.05),E/A值明显提高(P≤0.05),与对照组相比,治疗组改变更加明显(P≤0.05)。LVEDD、LVEF无明显改变(P>0.05)。结论叶酸联合维生素B12能明显降低CHF患者血清Hcy及NT-pro BNP水平,改善左心舒张功能,减轻CHF患者的临床症状。

Objective To investigate the effects of Folic acid combinatio- n with vitamin B12 on the level of Homocysteine（ Hcy） 、N- terminal brain natriuretic peptide（ NT- pro BNP） and left ventricular functionin in patients with chronic heart failure（ CHF）. Methods 120 patients with CHF were randomly divided into two groups： control group（ n= 62） was given routine therapy,experimental group（ n = 68） was treated with folic acid and vitamin B12 based on conventional drugs,course of treat- ment was 6 months; The serum levels of Hcy、NT- pro BNP and LVEDD、LVEF、E / A were measured before and after treatment. Results After treatment the serum levels of Hcy、NT- pro BNP were significantly lower,and E / A increased distinctly in both groups（ P≤0. 05）. Compared with the control group,experimental group changed significantly（ P≤0. 0 5）. There is no obvious change in LVEDD and LVEF. Conclusions After treatment by folic acid in combination with vitamin B12,the levels of Hcy,NT- pro BNP,left heart diastolic function and clinical symptoms in patients with CHF were improved.