实用医院临床杂志
實用醫院臨床雜誌
실용의원림상잡지
PRACTICAL JOURNAL OF CLINICAL MEDICINE
2014年
5期
36-38,39
,共4页
叶芳%羊洁%张欣%郭富强
葉芳%羊潔%張訢%郭富彊
협방%양길%장흔%곽부강
高同型半胱氨酸血症%脑梗死%B族维生素%斑块积分
高同型半胱氨痠血癥%腦梗死%B族維生素%斑塊積分
고동형반광안산혈증%뇌경사%B족유생소%반괴적분
Hyperhomocysteinemia%Acute ischemic stroke%B vitamins%Plaque scores
目的：探讨叶酸、维生素B6、甲钴胺联合治疗对急性脑梗死伴高同型半胱氨酸（ homocysteine ，Hcy）血症患者的血Hcy水平及颈动脉斑块积分的影响。方法将入组的52例急性脑梗死伴高Hcy血症患者采用区组随机法将其随机分为2组，干预组予叶酸2.5 mg qd，维生素B610 mg tid，甲钴胺500μg bid，持续3月；对照组除上述B族维生素治疗以外均与干预组相同。两组均于基线及3月时行血脂、血Hcy、颈动脉彩超检查，并行统计分析。结果两组干预后的总胆固醇（干预组内P＝0.022，对照组内P＜0.001）、LDL-C（干预组内P ＝0.016，对照组内P＜0.001）水平均较基线水平显著下降，甘油三酯及HDL-C水平无明显变化（ P＞0.05）；3个月时，干预组血Hcy水平（ P＜0.001）及斑块积分较基线时明显下降（ P ＝0.027），并且显著低于对照组（ t值分别为-5.164，-3.530；P值分别为＜0.001和0.001），而总胆固醇、甘油三酯、LDL-C及HDL-C水平与对照组比较差异无统计学意义（ P＞0.05）。结论叶酸、维生素B6、甲钴胺联合治疗高Hcy血症安全有效，且可明显减轻急性脑梗死患者动脉粥样硬化程度，是高Hcy人群缺血性卒中治疗的有益补充。
目的：探討葉痠、維生素B6、甲鈷胺聯閤治療對急性腦梗死伴高同型半胱氨痠（ homocysteine ，Hcy）血癥患者的血Hcy水平及頸動脈斑塊積分的影響。方法將入組的52例急性腦梗死伴高Hcy血癥患者採用區組隨機法將其隨機分為2組，榦預組予葉痠2.5 mg qd，維生素B610 mg tid，甲鈷胺500μg bid，持續3月；對照組除上述B族維生素治療以外均與榦預組相同。兩組均于基線及3月時行血脂、血Hcy、頸動脈綵超檢查，併行統計分析。結果兩組榦預後的總膽固醇（榦預組內P＝0.022，對照組內P＜0.001）、LDL-C（榦預組內P ＝0.016，對照組內P＜0.001）水平均較基線水平顯著下降，甘油三酯及HDL-C水平無明顯變化（ P＞0.05）；3箇月時，榦預組血Hcy水平（ P＜0.001）及斑塊積分較基線時明顯下降（ P ＝0.027），併且顯著低于對照組（ t值分彆為-5.164，-3.530；P值分彆為＜0.001和0.001），而總膽固醇、甘油三酯、LDL-C及HDL-C水平與對照組比較差異無統計學意義（ P＞0.05）。結論葉痠、維生素B6、甲鈷胺聯閤治療高Hcy血癥安全有效，且可明顯減輕急性腦梗死患者動脈粥樣硬化程度，是高Hcy人群缺血性卒中治療的有益補充。
목적：탐토협산、유생소B6、갑고알연합치료대급성뇌경사반고동형반광안산（ homocysteine ，Hcy）혈증환자적혈Hcy수평급경동맥반괴적분적영향。방법장입조적52례급성뇌경사반고Hcy혈증환자채용구조수궤법장기수궤분위2조，간예조여협산2.5 mg qd，유생소B610 mg tid，갑고알500μg bid，지속3월；대조조제상술B족유생소치료이외균여간예조상동。량조균우기선급3월시행혈지、혈Hcy、경동맥채초검사，병행통계분석。결과량조간예후적총담고순（간예조내P＝0.022，대조조내P＜0.001）、LDL-C（간예조내P ＝0.016，대조조내P＜0.001）수평균교기선수평현저하강，감유삼지급HDL-C수평무명현변화（ P＞0.05）；3개월시，간예조혈Hcy수평（ P＜0.001）급반괴적분교기선시명현하강（ P ＝0.027），병차현저저우대조조（ t치분별위-5.164，-3.530；P치분별위＜0.001화0.001），이총담고순、감유삼지、LDL-C급HDL-C수평여대조조비교차이무통계학의의（ P＞0.05）。결론협산、유생소B6、갑고알연합치료고Hcy혈증안전유효，차가명현감경급성뇌경사환자동맥죽양경화정도，시고Hcy인군결혈성졸중치료적유익보충。
Objective To study the impact of combination of folic acid , vitamin B6 and mecobalamine on homocysteine ( Hcy) levels and carotid artery plaque scores in acute ischemic stroke patients with hyperhomocysteinemia .Methods Fifty-two pa-tients were randomly divided into treatment and control group .The treatment group was treated with folic acid 2.5 mg qid, vitamin B6 10 mg tid, mecobalamine 500 μg bid for 3 months.The control group was treated the same as the treatment group except the B vita-mins.Blood lipid profiles , blood Hcy levels and carotid artery ultrasound score were recorded at baseline and 3 months after treatment . The data were statistically analyzed .Results After treatment, total cholesterol and LDL were significantly reduced when compared to the baseline in the both groups ( total cholesterol was P =0.022 within the treatment group and P <0.001 within the control group;LDL-C was P =0.016 within the treatment group and P<0.001 within the control group ) .However , no significant changes in triglyc-erides and HDL-C were found .After 3 months of treatment , blood Hcy levels and plaque scores in the treatment group were significant lower than that of the baseline ( t values were-5.164 and-3.530 , and P<0.001 and P =0.027 , respectively ) , even lower than that in the control group .No significant differences in total cholesterol , LDL-C, triglycerides and HDL-C were found between the two groups.Conclusion The combination of folic acid , vitamin B6 and mecobalamine were safe and effective to reduce not only homocys-teine levels but also the severity of atherosclerosis .This might be a beneficial supplementary therapy for patients with acute ischemic stroke and hyperhomocysteinemia .
