CAJ | 학술논문

目的：明确 B 族维生素及叶酸对降低 hcy ( hyperhomocysteinemia )的作用,明确 HHe (Hyperhomocysteinemia)是脑卒中的一个重要独立危险因素,B族维生素及叶酸是否对缺血性卒中复发干预有效。方法：采用随机双盲对照分析,治疗组及对照组各30例,治疗组：2.5mg叶酸、0.5mg 甲钴胺、VitB 620mg每日三次口服,连续服用到终点(2a)；对照组：安慰剂,连续服用到终点。观察同型半胱氨酸值服药后变化情况,观察服用B族维生素及叶酸后脑卒中复发情况(进行mRS评定)。结果：高同型半胱氨酸血症病人服用B族维生素及叶酸后6mo、1a后同型半胱氨酸值明显降低；HHe所致脑卒中病人,服用B族维生素及叶酸后1mo、6mo卒中复发无明显差异(P>0.05)；服用B族维生素及叶酸后1a、2a卒中复发有明显差异(P<0.05)),治疗组卒中复发明显减少；服药后无不良反应发生。结论：高同型半胱氨酸血症是脑卒中一个重要的独立危险因素,B族维生素及叶酸有效干预高同型半胱氨酸症所致脑卒中的复发及减少卒中发生,B族维生素及叶酸应作为是缺血性脑血管病一级、二级预防用药。
목적：명학 B 족유생소급협산대강저 hcy ( hyperhomocysteinemia )적작용,명학 HHe (Hyperhomocysteinemia)시뇌졸중적일개중요독립위험인소,B족유생소급협산시부대결혈성졸중복발간예유효。방법：채용수궤쌍맹대조분석,치료조급대조조각30례,치료조：2.5mg협산、0.5mg 갑고알、VitB 620mg매일삼차구복,련속복용도종점(2a)；대조조：안위제,련속복용도종점。관찰동형반광안산치복약후변화정황,관찰복용B족유생소급협산후뇌졸중복발정황(진행mRS평정)。결과：고동형반광안산혈증병인복용B족유생소급협산후6mo、1a후동형반광안산치명현강저；HHe소치뇌졸중병인,복용B족유생소급협산후1mo、6mo졸중복발무명현차이(P>0.05)；복용B족유생소급협산후1a、2a졸중복발유명현차이(P<0.05)),치료조졸중복발명현감소；복약후무불량반응발생。결론：고동형반광안산혈증시뇌졸중일개중요적독립위험인소,B족유생소급협산유효간예고동형반광안산증소치뇌졸중적복발급감소졸중발생,B족유생소급협산응작위시결혈성뇌혈관병일급、이급예방용약。
Objective:To clarify the effects of B-family vitamins and folic acid on lowering hcy, HHe being an important dangerous factor causing stroke,and whether B-family vitamins and folic acid are effective in interventing the recurring of ischemic cerebrovascular disease. Methods:A randomized double-blind controlled method is employed. There are 30 cases in both the controlled group and treatment group. The treatment group patients take 2. 5mg folic acid,0. 5mg mecobalamine and 620mg VitB,each P. O t. i. d lasting two years. The patients in the controlled group take placebo for two years. Then we observe the homocysteine value changes after mecobalamine are taken,and observe the stroke recurring demonstrations after the B-family vitamins and folic acid are taken ( The mRS evaluation is conducted) . Results:The homocysteine values of hyperhomocysteinemia patients go dwon significantly after they take B-family vitamins and folic acid after both six months and one year. The stroke recurring of HHe-caused stroke patients show no significant difference ( P>0 . 05 ) after they take B-family vitamins and folic acid after one month and six months. The recurring demonstrations show significant differences( P<0. 05 ) after they take continue to take the drugs till one year and two years. The treatment group patients have significantly lower recurring cases,and there are no untoward reactions or effects after the drugs are taken. Conclusions:Hyperhomocysteinemia is an important dangerous factor in causing stroke. The B-family vitamins and folic acid can effectively reduce stroke and intervene the recurring of stroke caused by hyperhomocysteinemia. The B-family vitamins and folic acid can be the primary and secondary prevention medicine against ischemic cerebrovascular disease.