叶酸联合维生素B12对老年精神分裂症伴发高同型半胱氨酸患者认知功能的影响

Effects of folic acid combined with vitamin B12 on cognitive function in elderly schizophrenic patients with high homocysteine

目的:探索叶酸(FA)联合维生素B12(VB12)对老年精神分裂症患者同型半胱氨酸(HCY)及认知功能影响。方法:纳入2021年3月上海市宝山区精神卫生中心160例老年精神分裂症伴有高HCY水平>15 mmol/L的患者,随机分为研究组80例和对照组80例。研究组每日服用1粒内含2 mg FA和400μgVB12的胶囊,对照组给予口服药用淀粉作为安慰剂,两组患者均按照上述方案连续治疗并观察16周。治疗前后检测血清同型半胱氨酸水平,评估重复性成套神经心理状态测验(RBANS)及阳性和阴性症状量表(PANSS)。比较治疗前后两组血清同型半胱氨酸水平、RBANS及PANSS量表的评分变化。结果:研究组的血清同型半胱氨酸水平较治疗前下降,较对照组也有所下降,差异均有统计学意义(P均<0.05);延迟记忆评分较治疗前增加,较对照组增加,差异均有统计学意义(P均<0.05);阴性症状及一般精神病理评分均较治疗前降低(P均<0.05),较对照组下降(P<0.001)。结论:FA联合VB12可以降低老年精神分裂症伴有高同型半胱氨酸水平患者的同型半胱氨酸水平,同时改善认知功能,缓解部分阴性症状及一般精神病理症状。

Objective:To explore the effect of folic acid(FA)combined with vitamin B12(VB12)on homocysteine(HCY)and cognitive function in elderly patients with schizophrenia.Method:A total of 160 elderly patients from Shanghai Baoshan District Mental Health Center in March 2021 with schizophrenia and high HCY levels>15 mmol/L were randomly divided into two groups,80 patients in the study group and 80 patients in the control group.The study group received a daily capsule containing 2 mg FA and 400μg VB12,while the control group received medicinal starch as placebo.Both groups were treated with the above regimen and observed for 16 weeks.Serum homocysteine levels were measured before and after treatment,and scores of Repeatable Battery for the Assessment of Neuropsychological Status(RBANS)and Positive and Negative Symptom Scale(PANSS)were evaluated.Compare the changes of serum homocysteine levels,RBANS and PANSS scores between the two groups before and after treatment.Results:The serum homocysteine level of the study group was significantly lower than that of the control group(all P<0.05);The delayed memory score was significantly higher than that of the control group(all P<0.05);The negative symptoms and general psychopathological scores were lower than those before treatment(all P<0.05),decreased compared with the control group(P<0.001).Conclusion:FA combined with VB12 can reduce homocysteine level in elderly schizophrenic patients with high homocysteine level,improve cognitive function,relieve some negative symptoms and general psychopathological symptoms.