60例短暂性脑缺血发作患者高同型半胱氨酸干预疗效观察  

A Controlled Study in 60 Cases of Transient Ischemic Attack Intervened for High Homocysteine

作　　者：唐海洋[1,2] 周仕钧[1] 彭海峰[1] 

机构地区：[1]湘潭市第一人民医院神经内科,湖南湘潭411101 [2]中南大学湘雅二医院

出　　处：《社区医学杂志》2013年第12期26-28,共3页Journal Of Community Medicine

摘　　要：目的观察具有高同型半胱氨酸血症的短暂性脑缺血发作患者,在甲钴胺及叶酸治疗后,血浆Hcy水平和TIA疗效、预后的关系。方法选60例高同型半胱氨酸血症的短暂性脑缺血发作患者随机分2组,治疗组和对照组,2组均给予常规抗血小板聚集、扩血管治疗,治疗组在此基础上给予叶酸片5mg 3次/日+甲钴胺片500ug 3次/日干预其高Hcy,连用3月。分别在入院第二天、治疗3月后采用荧光偏振免疫检测法测定2组患者Hcy水平,并进行ABCD评分、ESSEN评分,随访观察疗效、预后。结果治疗3月后治疗组血Hcy明显降低,而对照组Hcy无明显变化,两组比较差异有统计学意义(P<0.01);治疗组显效率、有效率明显高于对照组,两组比较差异有统计学意义(P<0.05)。结论甲钴胺、叶酸可降低血Hcy水平,提高TIA短期疗效、改善预后。Objective To observe the relationship between blood levels of homocysteine （Hcy） and the efficacy and prognosis of transient ischemic attack （TIA） in patients with high homocysteine, receiving methylcobalamin and folic. Methods Sixty TIA cases with hyperhomocysteinemia were randomly divided into two groups, treatment group and control group. Both groups were given conventional anti- platelet aggregation and vasodilator therapy. In addition, folio acid tab- lets were given to treatment group in a dose of 5mg, 3 times per day, and methylcobalami 500ug 3 times per day to in- terfere with the high Hcy levels for three consecutive months. Huorescence polarization immunoassay was used to deter- mine Hcy levels in both groups on the second day after admission and 3 months after treatment, which were then as- sessed with ABCD and ESSEN score. The efficacy and prognosis were observed in the follow - up visit. Results Threemonths after treatment, blood levels of Hcy decreased significantly in treatment group and no changes occurred in control group, which showed significant difference （ P 〈 0. 01 ）. The obvious improvement rate and effective rate increased signifi- cantly in treatment group than in control group, which showed significant difference （P 〈 0.05）. Conclusions Methylco- balamin and fo｜ic acid can reduce blood Hcy levels, improving the short - term efficacy and prognosis of TIA.

关 键 词：短暂性脑缺血发作 同型半胱氨酸 甲钴胺 叶酸 干预 

分 类 号：R743.3[医药卫生—神经病学与精神病学]