叶酸、VB6、VB12对高血压合并急性脑梗死患者血管内皮功能、血清同型半胱氨酸水平及生活质量的影响  

Influence of folic acid, vitamin B6 and vitamin B12 on vascular endothelial function,serum level of homocysteine and living quality in hypertensive patients with acute cerebral infraction

作　　者：俞敏[1] 黄庆梅[1] 覃鹏飞[1] YU Min;HUANG Qing-mei;QIN Peng-fei(Department of Neurology,Longgang Central Hospital,Shenzhen,Guangdong,518116,China)

机构地区：[1]广东省深圳市龙岗中心医院神经内科

出　　处：《心血管康复医学杂志》2019年第5期631-634,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:研究叶酸、维生素B6、B12对高血压合并急性脑梗死患者血管内皮功能,血清同型半胱氨酸(Hcy)水平及生活质量的影响。方法:本院2016年2月~2017年10月收治的高血压合并急性脑梗死患者92例被随机均分为常规治疗组与联合治疗组(在常规治疗基础上加用叶酸、维生素B6及维生素B12),两组均治疗12周。观察比较两组治疗前后血管舒张功能(FMD)、血清Hcy、一氧化氮(NO)水平、美国国立卫生研究院卒中量表(NIHSS)评分及Barthel指数评分。结果:与治疗前比较,治疗后两组血清Hcy水平、NIHSS评分均显著降低,Barthel指数评分均显著升高,治疗后联合治疗组血清NO[(50.20±11.18)μmol/L比(66.53±10.66)μmol/L]水平显著升高,P均<0.01。治疗前后两组FMD、常规治疗组血清NO水平均无显著差异,P均>0.05。与常规治疗组相比,联合治疗组治疗后血清Hcy[(21.58±2.24)μmol/L比(17.27±2.19)μmol/L]水平、NIHSS评分[(20.39±3.19)分比(16.12±1.15)分]降低更显著,NO水平[(53.76±11.67)μmol/L比(66.53±10.66)μmol/L],Barthel指数评分[(62.27±20.58)分比(79.58±21.24)分]升高更显著,P均=0.001。结论:叶酸、维生素B6及B12能显著改善高血压合并急性脑梗死患者血管内皮功能,降低血清Hcy水平、升高血清NO水平,改善神经功能缺损情况以及生活质量。值得临床推广应用。Objective: To study influence of folic acid, vitamin B 6 and vitamin B 12 on vascular endothelial function, serum level of homocysteine (Hcy) and living quality in hypertensive patients with acute cerebral infraction. Methods: A total of 92 hypertensive patients with acute cerebral infraction treated in our hospital from Feb 2016 to Oct 2017 were randomly and equally divided into routine treatment group and combined treatment group (received folic acid, vitamin B 6 and vitamin B 12 based on routine treatment group). Two groups were both treated for 12 weeks. Flow-mediated dilation (FMD), serum levels of Hcy and nitric oxide (NO), United States National Institutes of Health Stroke Score (NIHSS) score and Barthel index score before and after treatment were compared between two groups. Results: Compared with before treatment, after treatment, there were significant reductions in serum level of Hcy and NIHSS score, and significant rise in Barthel index score in two groups, and there was significant rise in serum level of NO[(50.20±11.18)μmol/L vs.(66.53±10.66)μmol/L] in combined treatment group, P <0.01 all. Before and after treatment, there were no significant difference in FMD in two groups, and no significant difference in serum level of NO in routine treatment group, P >0.05 all. Compare with routine treatment group, after treatment, there were significant reductions in serum level of Hcy[(21.58±2.24)μmol/L vs.(17.27±2.19)μmol/L] and NIHSS score[(20.39±3.19) scores vs.(16.12±1.15) scores], and significant rise in NO level[(53.76±11.67)μmol/L比(66.53±10.66)μmol/L], Barthel index score[(62.27±20.58)scores vs.(79.58±21.24)scores] in combined treatment group, P =0.001 all. Conclusion: Folic acid, vitamin B 6 and vitamin B 12 can effectively improve vascular endothelial function, reduce serum level of Hcy, increase serum level of NO, improve neurological function and activities of living quality, which is worth extending.

关 键 词：高血压 脑梗死 叶酸 高半胱氨酸 

分 类 号：R544.1[医药卫生—心血管疾病]