小剂量叶酸甲钴胺治疗对高Hcy老年急性腔隙性脑梗死患者临床观察.docVIP

小剂量叶酸甲钴胺治疗对高Hcy老年急性腔隙性脑梗死患者临床观察 　　【摘要】 目的 探讨小剂量叶酸、甲钴胺治疗对老年急性腔隙性脑梗死合并高同型半胱氨酸血症患者同型半胱氨酸水平及随访期脑血管事件的影响。方法 以发病3天内入院的老年急性腔隙性脑梗死患者163例为研究对象，随机分为观察组58例和对照组105例，观察组每日给予叶酸0.4mg和甲钴胺0.5mg，口服48周。对两组患者在入院时及此后连续4周、12周、24周、36周、48周进行同型半胱氨酸水平检测，并观察1年内脑卒中复发及急性脑供血不足发生情况，采用t或x2检验进行两组比较。结果 两组在第3周、4周、12周、24周、36周、48周同型半胱氨酸水平差异有统计学意义（P0.05），观察组急性脑供血不足发生与对照组比较差异有统计学意义 （P0.05）。结论 小剂量叶酸、甲钴胺治疗对老年急性腔隙性脑梗死伴高同型半胱氨酸血症患者能有效的降低同型半胱氨酸水平，干预治疗可能对1年脑卒中复发无影响，但可能减少急性脑供血不足的发生。 　　1 　　【关键词】腔隙性脑梗死；同型半胱氨酸；叶酸；甲钴胺；预后 中图分类号：R743 　　【Abstract】 Objective：To investigate junior folic acid and Mecobalamin on the eldly acute lacunar stroke patients with hyperhomocysteinemia. Methods：163 patients with acute lacunar stroke admitted to hospital within 3 days were observed，all were randomly divided into intervention group（58 cases） and control group（105 cases）.The patients in the intervention group were treated with folic acid 0.4mg and mecobalamin 0.5mg， 1 time every day for 48 weeks. The Hcy levels were observed in the day of admission，the day in successively 4 weeks ， the 12th week， 24th week， 36th week and 48th week. At the same time，the erebrovascular events were observed during the year.Then t test or x2were used for statistical analysis. Result：The significant differences were noted on the levels of homocysteine during the two groups in the 3th week，4th week， 12th week 24th week， 36th week and 48th week （P0.05）.There were no significant differences during the two groups in the recurrence of stroke. In comparation with the contrast group，the incidence of acute cerebral circulation insufficiency obviously declined in the intervention group （P0.05）. Conclusion：Junior folic acid and mecobalamin could effectively decrease the levels of homocysteine on the eldly acute lacunar stroke patients with hyperhomocysteinemia. Intervention may have no effect on the recurrence of stroke in 1 year， but may reduce the attack of acute cerebral circulation insufficiency. 　　【Key words】lacunar stroke； Homocysteine； Folic Acid；Mecoba