论文部分内容阅读
目的探讨血浆同型半胱氨酸水平(Hcy)和不同分型脑梗死之间的关系及脑梗死患者给予维生素B12和叶酸治疗前、后Hcy水平变化及其对预后的影响。方法检测206例脑梗死患者和51例正常人Hcy水平,并对脑梗死患者进行神经功能缺损评分(NIHSS)和进行分为进展性患者组、非进展性患者组,初发患者组和复发患者组,腔隙性脑梗死和脑血栓形成组,中青年患者组和老年患者组,观察各组的血浆同型半胱氨酸水平、NIHSS评分和给予维生素B12联合叶酸治疗,治疗4周后复测Hcy水平,并再次进行NIHSS评分。结果脑梗死患者组与对照组、进展性脑梗死患者组与非进展性患者组、初发患者组与复发性患者组、腔隙性脑梗死患者组与脑血栓形成组、中青年患者组与老年患者组的Hcy水平及NIHSS评分存在明显差异(P<0.01或P<0.05);以上不同分型脑梗死患者组与对照组的Hcy水平比较均存在显著差异(P<0.01),予以补充叶酸和维生素B12治疗后,脑梗死患者组Hcy水平明显下降,NIHSS评分显著降低(P<0.01)。结论以上各型脑梗死患者血浆Hcy水平显著升高,高同型半胱氨酸(Hhcy)是脑梗死患者的发生、发展、复发、病情程度、疾病转归的一个重要相关因素;脑梗死患者随年龄的增高Hcy水平显著升高;补充叶酸和维生素B12治疗有助于血浆Hcy水平的下降。
Objective To investigate the relationship between plasma homocysteine level (Hcy) and different types of cerebral infarction and the changes of Hcy level and its prognosis in patients with cerebral infarction treated with vitamin B12 and folic acid. Methods The levels of Hcy in 206 patients with cerebral infarction and 51 normal controls were detected. Neurological deficit scores (NIHSS) were measured in patients with progressive cerebral infarction and non-progressing patients, non-progressing patients, and recurrent patients Group, lacunar infarction and cerebral thrombosis group, middle-aged and young patients group and elderly patients group. Plasma homocysteine level, NIHSS score and vitamin B12 plus folic acid treatment were observed in each group. Hcy levels were measured after 4 weeks of treatment , And NIHSS score again. Results There was no significant difference between the group of cerebral infarction and the control group, the group of progressive cerebral infarction and the group of non-progressive patients, the group of primary and recurrent patients, the group of patients with lacunar infarction and the group of cerebral thrombosis, Hcy levels and NIHSS scores in elderly patients were significantly different (P <0.01 or P <0.05). There was significant difference (P <0.01) between the levels of Hcy in the above patients with different types of cerebral infarction and the control group, And vitamin B12 treatment, patients with cerebral infarction Hcy levels decreased significantly, NIHSS score was significantly lower (P <0.01). Conclusions Plasma homocysteine (Hcy) levels in patients with cerebral infarction above are significantly increased. Hcy is an important factor in the occurrence, development, relapse, severity of illness and prognosis of patients with cerebral infarction. Increased age Hcy levels were significantly higher; folic acid supplementation and vitamin B12 treatment contribute to the decline in plasma Hcy levels.