叶酸和维生素B_(12)对高Hcy急性脑梗死患者血Hcy水平及神经功能的影响

Effects of folic acid combined with vitamin B_(12) on serum Hcy level and neurological function in patients with acute cerebral infarction complicated with hyperhomocysteinemia

目的观察叶酸和维生素B12对高同型半胱氨酸(Hcy)急性脑梗死(ACI)患者血Hcy水平及神经功能的影响。方法选取100例高Hcy水平ACI患者为研究对象,随机分为观察组和对照组各50例。对照组患者给予常规治疗,观察组患者在常规治疗的基础上加用口服叶酸和维生素B12治疗。观察和比较2组患者治疗前后的血浆Hcy水平、血清一氧化氮(NO)水平、血清内皮素(ET)水平、日常生活能力量表(ADL)评分、美国国立卫生研究院卒中量表(NIHSS)评分。结果观察组患者治疗后血浆Hcy水平、血清NO水平、血清ET水平均较治疗前显著改善(t=25.146、-11.405、15.493,P<0.05),且均优于对照组(t=-26.364、10.550、-15.181,P<0.05);2组患者治疗后NIHSS评分、ADL评分均较治疗前显著改善(t=22.802、16.870、-22.181、-11.871,P<0.05),且观察组患者治疗后的NIHSS评分、ADL评分均显著优于对照组(t=-7.798、10.516,P<0.05)。结论应用叶酸和维生素B12治疗ACI,能够降低血浆Hcy水平,改善血管内皮功能,促进神经功能的恢复,增强日常生活能力,有助于改善患者的生存质量和预后。

Objective To observe the effects of folic acid combined with vitamin B12 on serum homocysteine（Hcy） level and neurological function in patients with acute cerebral infarction （ACI） complicated with hyperhomocysteinemia .Methods＆amp;nbsp;One hundred patients with ACI complicated with hyperhomocysteinemia were selected as research subjects and randomly divid‐ed into observation group and control group ,50 cases in each group .The patients in the control group were treated with the conventional treatment ,while the patients in the observation group were treated with oral folic acid combined with vitamin B 12 on the basis of the conventional treatment .The plasma Hcy levels ,the serum nitric oxide（NO） level ,the serum endothelin（ET） level ,the National Institute of Health Stroke Scale（NIHSS） scores ,the Activity of Daily Living Scale（ADL） scores before and after the treatment in the two groups were observed and compared .Results The plasma Hcy level ,the serum NO level ,the se‐rum ET level after the treatment in the observation group were significantly improved compared with those before the treat‐ment（t=25.146 ,-11.405 ,15.493 ,P〈0.05） and those in the control group（t= -26.364 ,10.550 ,-15.181 ,P〈0.05）;The NIHSS scores and the ADL scores after the treatment in two groups were significantly improved compared with those before the treatment（t=22.802 ,16.870 ,-22.181 ,-11.871 ,P〈 0.05） ,and the observation group got better NIHSS scores and ADL scores relative to the control group（t= -7.798 ,10.516 ,P〈0.05） .Conclusion The application of folic acid combined with vitamin B12 in the treatment of ACI can reduce the plasma Hcy level ,improve the vascular endothelial function ,promote the recovery of neurological function ,strengthen the ability of daily life and help to improve the quality of life and prognosis .