叶酸联合维生素B12对高同型半胱氨酸脑梗死患者深静脉血栓形成的影响  

Effects of Folic Acid Combined with Vitamin B12 on Deep Vein Thrombosis in Patients with Homocysteine Cerebral Infarction

作　　者：于磊 丛时兵[1] 李建桥 YU Lei;CONG Shi-bing;LI Jian-qiao(Department of Neurology,Suixi County Hospital,Huaibei 235100,China)

机构地区：[1]安徽省濉溪县医院神经内二科,安徽淮北235100

出　　处：《药物生物技术》2020年第4期352-355,共4页Pharmaceutical Biotechnology

摘　　要：高同型半胱氨酸(Hcy)与深静脉血栓形成之间的关系已成为近年来的研究热点。各种研究表明,血浆Hcy的代谢过程与叶酸和维生素B12密切相关。该研究叶酸联合维生素B12对Hcy脑梗死患者深静脉血栓形成(DVT)的影响。选择2016年1月至2019年7月入院的70例DVT高同型半胱氨酸脑梗死患者作为研究对象。将他们随机分为两组,观察组(n=35)和对照组(n=35),两组患者在年龄,性别,体重等方面无明显差异,具有可比性(P<0.05)。两组患者在常规标准的治疗方案基础上,观察组给予叶酸和维生素B12,而对照组组不给予叶酸和维生素B12。通过测定两组患者治疗前后血清中Hcy,叶酸和维生素B12的浓度变化,对Hcy和叶酸与维生素B12的相关性进行分析,同时对两组患者的抗凝国际标准化比率(INR)进行了比较分析。通过彩色多普勒超声对两组复发性血栓形成的观察,首次将INR详细记录为标准时间,稳定值时间,获得稳定INR值时间,活化部分凝血活酶时间(APTT)和凝血酶原时间(PT)。结果显示,经治疗后,虽然对照组和观察组的Hcy均有下降,但是对照组在治疗前后的Hcy、叶酸和维生素B12差异不明显。与对照组相比,观察组的患者Hcy下降更为显著(P<0.05),而叶酸和维生素B2浓度显著升高,两组差异具有统计学意义(P<0.05).通过分析发现,在观察组中,Hcy浓度增长趋势与叶酸浓度呈负相关(r=-0.376,P<0.05),同时Hcy浓度增长与维生素B12浓度呈负相关(r=-0.583,P<0.05)。此外,与对照组相比,观察组患者的INR中的标准时间、达到稳定值时间均显著增加(P<0.05),但是观察组的APTT平均值和PT值却显著要低于对照组,差异具有统计学意义(P<0.05)。在观察组中,下肢深静脉血栓形成复发率为4.4%,低于对照组组下肢深静脉血栓形成复发率28.9%(P<0.05)。该研究显示叶酸治疗急性脑梗死伴高Hcy血症有明显效果;应用叶酸可明显降低Hcy。The relationship between homocysteine(Hcy)and deep vein thrombosis(DVT)has become a hot topic of research in recent years.Various studies have shown that the metabolic process of plasma Hcy is closely related to folic acid and vitamin B12.This study investigated the effect of folic acid combined with vitamin B12 on deep vein thrombosis(DVT)in patients with Hcy infarction.Seventy patients with DVT hyperhomocysteine cerebral infarction who were admitted from January 2016 to July 2019 were selected as study subjects.They were randomly divided into two groups,observation group(n=35)and control group(n=35).There were no significant differences in gender,weight,age etc.,which were comparable(P<0.05).The study groups were given folic acid and vitamin B12 in addition to the usual standard treatment,while the control group was no given folic acid and vitamin B12.By measuring the changes in the serum concentrations of Hcy,folic acid and vitamin B12 before and after treatment in two groups of patients,the effect of Hcy,folic acid,and vitamin B12 on the concentration of vitamin B12 was investigated.The correlation between Hcy and folic acid with vitamin B12 was analyzed,and the International Standardized Ratio(INR)of anticoagulation in both groups were analyzed comparatively.For the first time,INR was recorded in detail as standard time by color Doppler ultrasound of recurrent thrombosis in both groups,with stable values time,time to obtain stable INR values,activated partial thromboplastin time(APTT)and prothrombin time(PT).The results showed that,although Hcy decreased in both control and observation groups after treatment but before and after treatment in the control group had no significant differences in Hcy,folic acid and vitamin B12.Compared to the control group,patients in the observation group had a more significant decreased in Hcy(P<0.05),while the concentrations of folate and vitamin B12 significantly increased,the difference between the two groups was statistically significant(P<0.05).The analysis revealed that

关 键 词：叶酸 维生素B12 深静脉血栓形成 下肢 脑梗死 高同型半胱氨酸 

分 类 号：Q563[生物学—生物化学] R743[医药卫生—神经病学与精神病学]