叶酸对老年脑梗死伴高血压患者同型半胱氨酸水平和认知功能的影响  

Effect of folic acid on plasma homocysteine levels and cognitive function in elderly patients with cerebral infarction and hypertension

作　　者：宋文娟[1] 吴俊[1] 高荣[1] 潘宁丰[1] 陈晗[1] 刘海燕[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210008

出　　处：《实用老年医学》2012年第6期507-510,共4页Practical Geriatrics

摘　　要：目的探讨叶酸对老年脑梗死伴高血压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1～6月南京市市级机关医院神经内科住院腔隙性脑梗死并高血压患者120例,随机分成2组,A组60例,给予常规治疗加叶酸5mg,1次/日;B组60例,仅常规治疗而未给予叶酸治疗。测量2组入院后、治疗8周后Hcy水平,同时记录简易精神状态量表(MMSE)评分。对照组(排除脑梗死、高血压的同期住院患者)60例,于入院后测量Hcy水平,记录MMSE评分。结果老年脑梗死伴高血压(A+B)组血浆Hcy水平显著高于对照组(P<0.01),MMSE评分显著低于对照组(P<0.01)。老年脑梗死伴高血压A组血浆Hcy水平在叶酸治疗8周后较入院时明显下降(P<0.01),MMSE评分较入院时显著提高(P<0.01),同时MMSE评分提高明显大于B组(P<0.01)。结论叶酸能够明显降低老年脑梗死伴高血压患者血浆Hcy水平,显著改善患者的认知功能。Objective To explore the effect of folic acid on plasma homocysteine levels and cognitive function in the elderly patients with cerebral infarction and hypertension. Methods 120 elderly patients with lacunar cerebral infarction and hypertension were selected and divided randomly into two groups, Group A were treated with folic acid 5 mg/d, but group B were not treated. The patients of two groups also received routine treatment of ischemic stroke. Plasma homocysteine was measured at the time of admission and 8 weeks after treatment. The cognitive function was also evaluated by the Mini-Mental State Examination（MMSE） scale. In the same period （except the hospitalized patients with stroke and hypertension）, sixty patients without cerebral infarction and hypertension were chosen as control group, and admission plasma homocysteine was measured and the cognitive function was evaluated. Results The plasma level of homocysteine in the elderly patients with cerebral infarction and hypertension was higher than that in control group（P0.01）, and the MMSE score was obviously lower than that in control group（P0.01）. The plasma level of homocysteine in group A was reduced significantly after folic acid administration for 8 weeks（P0.01）, and the MMSE score was improved obviously at the same time（P0.01）. The improvement of MMSE score in group A was significantly higher than that in group B（P0.01）. Conclusions The treatment of folic acid reduces the level of plasma homocysteine and improves cognitive function in the elderly patients with cerebral infarction and hypertension.

关 键 词：叶酸 脑梗死 高血压 同型半胱氨酸 认知功能 

分 类 号：R544.1[医药卫生—心血管疾病] R743.3[医药卫生—内科学]