甲钴胺联合叶酸治疗急性脑梗死伴高同型半胱氨酸血症患者的效果

Effects of Mecobalamin combined with Folic acid in treatment of patients with acute cerebral infarction and hyperhomocysteinemia

目的:观察甲钴胺联合叶酸治疗急性脑梗死伴高同型半胱氨酸血症患者的效果。方法:选取68例急性脑梗死伴高同型半胱氨酸血症患者为研究对象,按照随机数字表法分为观察组与对照组各34例。两组均给予常规治疗,在此基础上,对照组给予叶酸治疗,观察组在对照组基础上给予甲钴胺治疗,比较两组疗效、美国国立卫生院卒中量表(NIHSS)评分、同型半胱氨酸水平、超敏C反应蛋白(hs-CRP)水平、血脂指标[总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL-C)及低密度脂蛋白(LDL-C)]水平和不良反应发生率。结果:观察组治疗总有效率为97.06%,明显高于对照组的76.47%,差异有统计学意义(P<0.05);治疗1、3个月,观察组NIHSS评分明显均低于对照组,差异有统计学意义(P<0.05);治疗后,两组血浆同型半胱氨酸和hs-CRP水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后,观察组TC、LDL-C水平均低于对照组,差异有统计学意义(P<0.05);治疗后,两组TG、HDL-C水平比较,差异无统计学意义(P>0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:在常规治疗基础上采用甲钴胺联合叶酸治疗急性脑梗死伴高同型半胱氨酸血症患者可提高治疗总有效率,降低NIHSS评分及同型半胱氨酸、hs-CRP、TC和LDL-C水平,效果优于叶酸联合常规治疗。

Objective: To observe effects of Mecobalamin combined with Folic acid in treatment of patients with acute cerebral infarction and hyperhomocysteinemia. Methods: 68 patients with acute cerebral infarction and hyperhomocysteinemia were selected as the research objects and were divided into observation group and control group according to the random number table method, 34 cases in each group. Both groups were given conventional treatment. On this basis, the control group was given Folic acid treatment, while the observation group used Mecobalamin treatment on the basis of that of the control group. The curative effects, the National Institutes Of Health Stroke Scale(NIHSS) score, the homocysteine level, the high-sensitivity C-reactive protein(hs-CRP) level, the blood lipid index levels [total cholesterol(TC), triacylglycerol(TG),, high-density lipoprotein(HDL-C) and low-density lipoprotein(LDL-C)], and incidence of adverse reactions were compared between the two groups. Results:The total effective rate of the observation group was 97.06%, which was significantly higher than the control group of 76.47%, and the difference was statistically significant(P<0.05). After 1 month and 3 months of treatment, the NIHSS scores of the observation group were significantly lower than those of the control group, and the differences were statistically significant(P<0.05). After the treatment, the levels of plasma homocysteine and hsCRP in the two groups were lower than those before the treatment, those of the observation group were lower than those of the control group, and the differences were statistically significant(P<0.05). After the treatment, the levels of TC and LDL-C in the observation group were lower than those in the control group, and the differences were statistically significant(P<0.05). After the treatment, there was no significant difference in the levels of TG and HDL-C between the two groups(P>0.05). Further, there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusions: On the basis of the conventional treatment, Mecobalamin combined with Folic acid in the treatment of the patients with acute cerebral infarction and hyperhomocysteinemia can improve the total effective rate of treatment, and reduce the NIHSS score, the homocysteine level, the hs-CRP level, the TC levels and the LDL-C level. Moreover, it is superior to Folic acid combined with the conventional treatment.