甲钴胺与维生素B_(12)治疗早期脊髓亚急性联合变性临床研究

A comparative analysis of the efficacy of mecobalamin and vitamin B_(12) in the treatment of early subacute combined degeneration of the spinal cord

目的:探讨甲钴胺与维生素B_(12)治疗早期脊髓亚急性联合变性(SCD)的疗效差异。方法:将确诊为SCD的64例患者均分为两组,维B组在常规治疗基础上注射维生素B_(12)和维生素B_1,钴胺组则肌注甲钴胺实施治疗。对比两组治疗前后红细胞数目、血红蛋白及血清维生素B_(12)变化;从步态、感觉障碍及锥体束受累3个维度评估两组患者神经系统损伤程度;统计两组治疗效果及不良反应情况。结果:治疗后,两组红细胞数目、血红蛋白及血清维生素B_(12)水平均明显升高(P<0.05),步态、感觉障碍及锥体束受累3个维度的神经系统损伤评分明显下降(P<0.05),且钴胺组红细胞数目、血红蛋白水平均明显高于维B组(P<0.05),3个维度神经系统损伤评分明显低于维B组(P<0.05),但两组治疗后在血清B_(12)水平间差异无统计学意义(P>0.05)。钴胺组总有效率为93.75%,明显高于维B组(75.00%)(P>0.05),但两组不良反应发生情况间差异无统计学意义(P>0.05)。结论:甲钴胺是治疗早期SCD的有效药物,可有效改善患者贫血症状,促进神经系统损伤恢复,改善患者生活质量,且安全性高。

Objective To investigate the effect of mecobalamin and vitamin B（12） in the treatment of early subacute combined degeneration（SCD）of the spinal cord.Methods The 64 patients who were diagnosed as SCD in the outpatient department of neurology department of Shaanxi Provincial Friendship Hospital from January 2015 to February 2018 were divided into two groups.In group B,vitamin B（12） and vitamin B1 were injected on the basis of conventional treatment,cobalamin group was treated with intramuscular mecobalamin.The changes in the number of red blood cells,hemoglobin,and serum vitamin B（12） before and after treatment were compared in both groups.The degree of nervous system damage was evaluated in three dimensions of gait,sensory disturbance and pyramidal tract involvement.The treatment effects and adverse reactions of the two groups were recorded.Results After treatment,the number of red blood cells,hemoglobin,and serum vitamin B（12） levels increased significantly in both groups（P〈0.05）,three-dimensional neurological impairment scores for gait,sensory impairment,and pyramidal tract involvement decreased significantly（P〈0.05）,and the number of red blood cells and hemoglobin were significantly higher in the Cobalamin group than those in Group B（P〈0.05）,three-dimensional neurological impairment scores of neurological injury were significantly lower than those in group B（P〈0.05）.However,there was no significant difference in serum B（12） levels between the two groups after treatment（P〉0.05）.The total effective rate of the cobalamin group was 93.75%,which was significantly higher than that in group B（75.00%）（P〈0.05）.However,there was no significant difference in the incidence of adverse reactions between the two groups（P〉0.05）.Conclusion：Methylcobalamin is an effective drug for the treatment of early SCD,which can effectively improve the symptoms of anemia in patients,promote the recovery of nervous system damage,improve the quality of life of patients,and have high safety.