不同剂量叶酸对老年脑梗死患者同型半胱氨酸水平和认知功能的影响  

Effects of different doses of folic acid on plasma homocysteine levels and cognitive function in the elderly patients with cerebral infarction

作　　者：宋文娟[1] 吴俊[1] 

机构地区：[1]南京市市级机关医院神经内科,江苏省南京市210018

出　　处：《实用老年医学》2013年第11期920-923,共4页Practical Geriatrics

摘　　要：目的探讨不同剂量叶酸对老年脑梗死患者血浆同型半胱氨酸水平(Hcy)和认知功能的影响。方法入选2012年3~12月南京市市级机关医院神经内科住院老年腔隙性脑梗死患者165例,随机分成3组,每组55例,A组给予叶酸5 mg,1次/d;B组给予叶酸10 mg,1次/d;C组未给予叶酸治疗;3组患者同时接受缺血性卒中常规治疗。检测入院后、治疗8周后Hcy水平,同时记录简易精神状态量表(MMSE)评分。结果治疗8周后A组与B组血浆Hcy水平较治疗前均明显降低(P<0.05),同时明显低于C组治疗后同期水平(P<0.05),A组与B组治疗后血浆Hcy水平比较无明显差异(P>0.05)。3组治疗8周后MMSE评分均较治疗前明显提高(P<0.05),A组与B组治疗后MMSE评分优于C组(P<0.05),但2组间比较无明显差异(P>0.05)。结论叶酸能够明显降低老年脑梗死患者血浆Hcy水平,显著改善患者的认知功能;但叶酸剂量>5 mg/d后,增加剂量对于降低Hcy、提高MMSE评分与5 mg/d相比无明显差异。Objective To explore the effects of different doses of folic acid on plasma homocysteine levels and cognitive function in the elderly patients with cerebral infarction. Methods 165 elderly patients with lacunar cerebral infarction from Department of Neurology of Nanjing Governmental Hospital,were randomly divided into 3 groups,55 cases in each group. Group A was treated with 5mg / d of folic acid,group B treated with 10mg / d,and group C did not receive the treatment of folic acid. The patients were all given regular treatment for ischemic stroke. Plasma homocysteine was measured at the time of admission and 8 weeks after the treatment. The cognitive function was also evaluated by the Mini-Mental State Examination( MMSE) scale. Results After 8 weeks' treatment,the plasma level of homocysteine was significantly decreased in groups A and B( P < 0. 05). Meanwhile,the plasma level of homocysteine in groups A and B was significantly lower than that in group C( P < 0. 05),but there was no significant difference between groups A and B( P > 0. 05). The MMSE scores were improved obviously in 3 groups 8 weeks after treatment( P < 0. 05). The improvement of MMSE scores in groups A and B were significantly higher than that in group C( P < 0. 05),but there was no difference between group A and B( P > 0. 05). Conclusions The treatment of folic acid can reduce the level of plasma homocysteine and improve cognitive function in the elderly patients with cerebral infarction. The decreased degree of the homocysteine and improved MMSEs have no relationship with the dose of folic acid.

关 键 词：叶酸 剂量 老年人 脑梗死 同型半胱氨酸 认知功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]