脑梗死后认知功能障碍与血浆同型半胱氨酸水平关系及叶酸联合甲钴胺的干预作用

Relationship between plasma homocysteine levels and cognitive dysfunction after cerebral infarction and the intervention effect of folic acid combined with methylcobalamin

目的观察脑梗死后认知功能障碍与血浆同型半胱氨酸(Hcy)水平关系及叶酸联合甲钴胺的干预作用。方法血浆Hcy水平采用荧光偏振免疫分析法进行检测,比较脑梗死后认知功能障碍患者(n=78)和认知功能正常患者(n=82)的血浆Hcy水平;将脑梗死后认知功能障碍患者随机分为治疗组和对照组各39例,对照组给予常规治疗,治疗组在对照组常规治疗的基础上加用叶酸联合甲钴胺,检测记录Hcy水平及MMSE分值。结果脑梗死后认知功能障碍患者血浆Hcy水平为(24.61±4.27)μmol/L高于认知功能正常患者的(18.93±5.66)μmol/L;治疗后治疗组患者MMSE分值明显高于治疗前及对照组,其血浆Hcy水平明显低于治疗前及对照组;差异均有统计学意义(P<0.05)。对照组治疗前后的血浆Hcy水平和MMSE分值均无显著变化(P>0.05)。结论血浆Hcy水平的高低对脑梗死后认知功能障碍的发生和程度具有一定影响,叶酸联合甲钴胺对脑梗死后认知功能障碍患者认知能力的改善具有积极作用。

Objective To investigate the relationship between plasma homocysteine levels and cognitive dysfunction after cerebral infarction and the intervention effect of folic acid combined with methylcobalamin. Methods The plasma homocysteine( Hcy) levels was detected by fluorescence polarization immunoassay analysis method,compared the Hcy levels of cerebral infarction cognitive dysfunction( n = 78) and cognitive function normal( n = 82); The cerebral infarction cognitive dysfunction patients were randomly divided into treatment group and control group,each of 39 cases. Control group received conventional therapy. On the basis of control group,treatment group were treated with folic acid combined with methylcobalamin. Detected the level of plasma Hcy and MMSE score of two groups. Results After cerebral infarction,the plasma Hcy levels of cognitive dysfunction patients was( 24. 61 ± 4. 27) μmol / L higher than( 18. 93 ± 5. 66) μmol / L of normal cognitive function patients; After treatment,the MMSE scores of treatment group were significantly higher than before treatment and control group,the plasma Hcy levels of treatment group were significantly lower than before treatment and control group; the difference was statistically significant( P < 0. 05). In the control group before and after treatment the plasma Hcy levels and MMSE scores did not change significantly( P > 0. 05). Conclusion The plasma Hcy levels has certain influence on the occurrence and the degree of cognitive dysfunction after cerebral infarction,folic acid combined with mecobalamin on cerebral infarction after the cognitive dysfunction in patients with cognitive ability plays an active role in improving.