Hcy对重组人促红素改善急性脑梗死患者认知功能障碍的影响

Effect of Hcy on Recombinant Human Erythropoietin to Improve Cognitive Dysfunction in Patients with Acute Cerebral Infarction

目的探讨同型半胱氨酸(Hcy)在重组人促红素(rHu-EPO)改善急性脑梗死患者认知功能障碍中的作用。方法将2017年1月~2018年12月收入西安市第三医院ICU的54例急性脑梗死合并认知功能障碍患者随机分为对照组(28例)和治疗组(26例),对照组进行急性脑梗死的常规治疗,治疗组在常规治疗的基础上加用rHu-EPO 30 IU/kg皮下注射。检测治疗前和治疗后血清EPO、Hcy水平,Pearson相关分析判别血清Hcy与EPO水平的相关性。采用蒙利特尔认知评估量表(MoCA)评估治疗前后患者神经认知功能的变化,采用美国国立卫生研究院神经功能缺损评分标准(NIHSS)评估治疗前后患者神经功能缺损评分的变化。结果两组治疗4周后血清EPO水平、MoCA总分、语言能力、延迟回忆能力评分高于治疗前,同型半胱氨酸(Hcy)水平、NIHSS评分低于治疗前,且治疗组优于对照组(P<0.05),Pearson相关分析显示血清Hcy与EPO水平呈负相关。结论在常规治疗的基础上加用rHu-EPO对急性脑梗死患者认知功能具有改善作用,其机制可能与降低Hcy水平有关。

Objective To investigate the role of homocysteine(Hcy)in the improvement of the cognitive dysfunction of patients with acute cerebral infarction by recombinant human erythropoietin(rHu-EPO).Methods 54 patients with acute cerebral infarction combined with cognitive dysfunction who were admitted to the ICU of Xi'an Third Hospital from January 2017 to December 2018 were randomly divided into a control group(28 cases)and a treatment group(26 cases).For the conventional treatment of acute cerebral infarction,the treatment group was injected with rHu-EPO 30 IU/kg subcutaneously on the basis of conventional treatment.Serum EPO and Hcy levels were detected before and after treatment,and Pearson correlation analysis was used to determine the correlation between serum Hcy and EPO levels.The Monlitell Cognitive Assessment Scale(MoCA)was used to evaluate the changes in the patients'neurocognitive function before and after treatment,and the National Institutes of Health Neurological Impairment Score(NIHSS)was used to assess the changes in the patients'neurological deficit score before and after treatment.Results After 4 weeks of treatment,the serum EPO levels,MoCA total scores,language ability,and delayed recall scores of the two groups were higher than before treatment,and homocysteine(Hcy)levels and NIHSS scores were lower than before treatment,and the treatment group was better than the control group(P<0.05).Pearson correlation analysis showed that serum Hcy and EPO levels were negatively correlated.Conclusion The addition of rHu-EPO on the basis of conventional treatment could improve the cognitive function of patients with acute cerebral infarction,and its mechanism might be related to the reduction of Hcy levels.