叶酸联合VitB_(12)对血管性认知障碍患者血浆Hcy水平的影响  

The effect of folic acid combined with VitB12 on plasma homocysteine(Hcy) level in the treatment of patients with vascular cognitive impairment

作　　者：张建勋[1] 任星[1] 文师访 徐达青[1] 高秀先[1] 汪进丁[1] 

机构地区：[1]江西省九江市第一人民医院神经内科,九江332000

出　　处：《上海医药》2016年第5期26-30,共5页Shanghai Medical & Pharmaceutical Journal

基　　金：2015年江西省卫生厅科研计划(普通)课题(项目编号:20155005)

摘　　要：目的:探讨叶酸联合VitB_(12)对血管性认知障碍患者血浆同型半胱氨酸(homocysteine,Hcy)水平的影响及其意义。方法 :选取我院神经内科血管性认知障碍患者120例,采用随机数字表法将患者分为两组,各60例,对照组采用常规治疗;观察组在对照组基础上加用叶酸联合VitB_(12)治疗,采用荧光偏振免疫法检测血浆Hcy水平,微粒子酶联免疫法检测血浆叶酸、VitB_(12)水平,比较两组患者治疗前后血浆Hcy、叶酸、VitB_(12)水平,以及简易精神状态检查量表(mini-mental state examine,MMSE),蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)评分,神经精神问卷(neuropsychological index,NPI)与日常生活活动能力量表(activities of daily living,ADL)评分。结果 :治疗前,两组患者血浆Hcy、叶酸、VitB_(12)水平,MMSE、MoCA、NPI、ADL评分比较差异无统计学意义(P>0.05);治疗后,观察组血浆Hcy水平,NPI、ADL评分明显低于对照组与治疗前,比较差异具有统计学意义(P<0.05)。观察组血浆叶酸、VitB_(12)水平,MMSE、MoCA评分明显高于对照组与治疗前,比较差异具有统计学意义(P<0.05)。且在治疗期间,未发生药品不良反应。结论:叶酸联合VitB_(12)治疗有助于显著降低血管性认知障碍患者血浆Hcy水平,从而显著改善认知功能、精神行为症状与生活质量,值得临床推广应用。Objective： To investigate the effect of folic acid combined with vitamin B12 （VitB12） on the plasma homocysteine （Hcy） level in the treatment of patients with vascular cognitive impairment and its significance. Methods： One hundred and twenty patients with vascular cognitive impairment in our department were selected and randomly divided into an observation group and a control group with 60 cases each. The control group was treated with conventional therapy and the observation group was additionally treated with folic acid combined with VitB12 on the base of control group. Plasma Hcy level was detected by fluorescence polarization immunoassay and the levels of plasma folic acid and VitB12 were detected by microparticle enzyme linked immunoassay. The levels of plasma Hcy, folic acid and VitB12, mini-mental state examine （MMSE）, Montreal cognitive assessment （MoCA）, neuropsychological index （NPI） and scores of the activities of daily life （ADL） were compared between the two groups before and after treatment. Results： Comparison of the levels of plasma Hcy, folic acid and VitB12 and the scores of MoCA, NPI and ADL between the two groups showed no statistical significance before treatment （P〉0.05）. Plasma Hcy levels as well as NPI and ADL scores were significantly lower in the observation group than control group and after treatment than before （P〈0.05） while the levels of plasma folic acid and VitBl〉 and the scores of MMSE and MoCA were significantly higher in the observation group than control group （P〈0.05）. Furthermore, the adverse drug reactions were not found during the treatment. Conclusion： The therapy of folic acid combined with VitB12 can significantly reduce the plasmaHcy level of the patients with vascular cognitive impairment and therefore can significantly improve cognitive function, mental behavior symptoms and life quality, and is worthy of clinical application.

关 键 词：叶酸 维生素B12 血管性认知障碍 同型半胱氨酸 

分 类 号：R749.13[医药卫生—神经病学与精神病学] R749.053[医药卫生—临床医学]