维生素B12联合叶酸治疗缺血性脑卒中的疗效及对血浆Hcy水平的影响  

Effect of Vitamin B12 Combined with Folic Acid in the Treatment of Ischemic Stroke and Plasma Hcy level

作　　者：郭锋 张凤岐 史九波[1] GUO Feng;ZHANG Feng-qi;SHI Jiu-bo(Sanmenxia Central Hospital,Henan Sanmenxia 472000)

机构地区：[1]三门峡市中心医院,河南三门峡472000

出　　处：《深圳中西医结合杂志》2023年第1期16-18,共3页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

基　　金：三门峡市科技攻关项目(2020040331)。

摘　　要：目的:探讨维生素B12联合叶酸治疗缺血性脑卒中的临床疗效及对血浆同型半胱氨酸(Hcy)水平的影响。方法:选取2020年7月至2022年3月三门峡市中心医院收治的缺血性脑卒中患者136例为研究对象,依据治疗方式不同分为常规组(66例)和联合组(70例),常规组患者接受缺血性脑血管病的规范化治疗,联合组在常规组基础上服用维生素B12片和叶酸片,两组患者均治疗4周,比较治疗前后两组患者的血浆Hcy、叶酸和维生素B12水平,神经功能缺损量表(NIHSS)和日常生活活动能力评定量表(ADL)评分,并记录随访期内的脑卒中事件复发情况。结果:两组患者治疗前血浆Hcy、叶酸、维生素B12水平、NIHSS、ADL评分比较,差异均无统计学意义(P> 0.05),治疗后联合组血浆Hcy水平低于常规组,血浆叶酸和维生素B12水平高于常规组,差异具有统计学意义(P <0.05)。治疗后联合组患者ADL评分高于常规组,NIHSS评分低于常规组,差异具有统计学意义(P <0.05)。随访期间联合组患者复发率为6.67%,低于常规组的26.67%,差异具有统计学意义(P <0.05)。结论:在缺血性脑卒中治疗中,采用维生素B12联合叶酸方案可改善患者血浆Hcy、叶酸和维生素B12水平,提高临床治疗效果,减轻神经功能受损程度,提高日常生活活动能力,降低复发率。Objective To investigate the clinical efficacy of vitamin B12 combined with folic acid in the treatment of ischemic stroke and the effect on plasma homocysteine(Hcy)level.Methods A total of 136 patients with ischemic stroke admitted to Sanmenxia Central Hospital from July 2020 to March 2022 were selected as the study objects and divided into conventional group(66 cases)and combined group(70 cases)according to different treatment methods.Patients in the conventional group received standardized treatment for ischemic cerebrovascular disease,and the combined group received vitamin B12 tablets and folic acid tablets in addition to the conventional group.Both groups were treated for 4 weeks.Plasma levels of Hcy,folic acid and vitamin B12,scores of National Institute of Health stroke scale(NIHSS)and activity of daily living(ADL)before and after treatment were compared between the two groups,and recurrent stroke events during the follow-up period were recorded.Results Before treatment,there was no significant difference in plasma Hcy,folic acid,vitamin B12,NIHSS and ADL scores between the two groups(P>0.05).After treatment,the plasma Hcy level of the combined group was lower than that of the conventional group,while the plasma folic acid and vitamin B12 levels were higher than that of the conventional group,the differences were statistically significant(P<0.05).After treatment,ADL score in the combination group was higher than that in the conventional group,and NIHSS score was lower than that in the conventional group,and the differences were statistically significant(P<0.05).During the follow-up period,the recurrence rate of patients in the combination group was 6.67%,lower than 26.67%in the conventional group,and the difference was statistically significant(P<0.05).Conclusion In the treatment of ischemic brain stroke,the combination of vitamin B12 and folic acid can improve the plasma levels of Hcy,folic acid and vitamin B12,improve the clinical therapeutic effect,reduce the degree of neurological impairment,improve t

关 键 词：缺血性脑卒中 叶酸 维生素B12 同型半胱氨酸 

分 类 号：R743.3[医药卫生—神经病学与精神病学]