脑梗死后认知功能障碍患者血浆同型半胱氨酸水平及叶酸、甲钴胺的治疗作用  

The levels of palsma homocystein in patients with cognitive impairment after cerebral infarction and the effect of folic acid and mecobalamine

作　　者：秦锦标[1] 

机构地区：[1]东南大学医学院附属南京江北人民医院神经内科,江苏210048

出　　处：《脑与神经疾病杂志》2010年第6期449-451,共3页Journal of Brain and Nervous Diseases

摘　　要：目的探讨脑梗死后认知功能障碍与同型半胱氨酸(Hcy)的关系,观察叶酸和甲钴胺对Hcy和认知功能的影响。方法应用荧光偏振免疫分析法测定血浆Hcy水平,比较脑梗死后认知功能障碍组患者和认知功能正常组患者Hcy水平。将脑梗死后认知功能障碍组患者按照有无接受叶酸和甲钴胺治疗随机分为治疗组和对照组,观察两组治疗前后Hcy水平及简易精神状态检查表(MMSE)分值的变化。分析Hcy与MMSE分值的相关性。结果脑梗死后认知功能障碍组患者血浆Hcy水平较认知功能正常组高;治疗组治疗后与治疗前相比,Hcy水平降低,MMSE分值升高;对照组治疗前、后Hcy水平及MMSE分值无明显变化;治疗组治疗后与对照组治疗后相比,Hcy水平降低,MMSE分值升高;脑梗死后认知功能障碍患者Hcy水平与MMSE分值呈负相关。结论脑梗死后认知功能障碍的发生和程度与血浆Hcy水平有关,联合应用叶酸和甲钴胺能改善脑梗死后认知功能障碍患者的认知功能。Objective To explore the relationship beteer cognitive impairment and the level of palsma homocystein（Hcy）in patients with cognitive impairment after cerebral infarction（CI） and to observe the intervention role of folic acid and mecobalamine to Hcy and cognition.Methods Fluorescence polarization analyse was applied to determine plasma Hcy level. The Hcy level was compared in the patients with cognitive impairment after CI and the patients with normal cognition. The patients with cognitive impairment after CI were randomly divided into treatment group and control group according to whether they had received folic acid and mecobalamine treatmen or not. The level of plasma Hcy and MMSE score were observed before and after treatment. The relating of the level and the MMSE score was analysed. Results The level of plasma Hcy in the patients with cognitive impairment after CI was higher than that in the patients with normal cognition. The level of plasma Hcy and MMSE score in treatment group after treatment respectively decreased and increased compared with before treatment. The level of plasma Hcy and MMSE score in control group had no significant difference between before and after treatment. After treatment, The level of plasma Hcy and MMSE score in treatment group respectively decreased and increased compared with the control group. The Hcy level was negative relation with the MMSE score in the patients with cognitive impairment after CI. Conclusion The incidence and the degree of cognitive impairment after CI are correlated with the level of plasma Hcy. The cognition of the patients with cognitive impairment after CI could be improved by adding folic acid and mecobalamine.

关 键 词：认知功能障碍 同型半胱氨酸 叶酸 甲钴胺 

分 类 号：R743.32[医药卫生—神经病学与精神病学]