中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2013年
7期
720-722
,共3页
钴胺酰胺类%脑梗死%高同种半胱氨酸血症%情感障碍
鈷胺酰胺類%腦梗死%高同種半胱氨痠血癥%情感障礙
고알선알류%뇌경사%고동충반광안산혈증%정감장애
Cobamides%Brain Infarction%Hyperhomocysteinemia%Mood disorders
目的 探讨甲钴胺对脑梗死伴高同型半胱氨酸(Hcy)血症的治疗作用及对脑梗死患者恢复期情绪障碍的疗效. 方法 收集2010年1月至2011年12月在我院神经内科住院的急性脑梗死伴高Hcy血症患者160例,并随机分成甲钴胺组和对照组各80例,两组除进行急性脑梗死治疗的常规处理外,甲钴胺组选用甲钴胺针剂500 μg(日本卫材株会社生产,批号:120476),肌肉注射,隔天1次,共8周,而对照组不进行其他治疗.采用酶免疫化学发光分析法测定血浆Hcy水平,应用症状自评量表SCL-90分析患者抑郁、焦虑和生活能力等方面的改善情况. 结果 对照组治疗前后血浆Hcy水平分别为(21.86±4.76)μmol/L和(18.67±3.81)μmol/L(t=0.40,P＞0.05),甲钴胺组患者治疗4周后血浆Hcy水平为(11.66±3.28) μmol/L,较治疗前(22.68±5.16) μmol/L明显下降(t=2.55,P＜0.01),与对照组治疗后比较差异也有统计学意义(t=7.40,P＜0.01).甲钴胺组治疗后SCL-90总分、阳性项目、阳性总分和阳性均分均显著优于治疗前(t=2.04、2.97、5.45、4.21,均P＜0.05),与对照组治疗后比较差异也有统计学意义(t=7.40、7.58、12.78、4.15,均P＜0.05),对照组治疗前后比较差异均无统计学意义(均P＞0.05).甲钴胺组治疗前后在躯体化、人际关系、抑郁、焦虑、恐怖及其他方面得分均高于治疗前(t=2.34、2.28、2.51、2.19、3.40、2.35,均P＜0.05)；与对照组治疗后在躯体化、人际关系、抑郁、焦虑、恐怖及其他方面得分比较差异也有统计学意义(t=4.10、5.04、5.12、4.18、5.48、5.20,均P＜0.05),而治疗前后偏执方面得分差异无统计学意义(t=1.40,P＞0.05),治疗组与对照组偏执方面得分差异无统计学意义(t=1.48,P＞0.05),对照组治疗前后比较差异均无统计学意义(均P＜0.05). 结论 甲钴胺能有效降低急性脑梗死伴高Hcy血症患者血浆Hcy水平,对患者焦虑、抑郁、紧张等情绪有缓解作用.
目的 探討甲鈷胺對腦梗死伴高同型半胱氨痠(Hcy)血癥的治療作用及對腦梗死患者恢複期情緒障礙的療效. 方法 收集2010年1月至2011年12月在我院神經內科住院的急性腦梗死伴高Hcy血癥患者160例,併隨機分成甲鈷胺組和對照組各80例,兩組除進行急性腦梗死治療的常規處理外,甲鈷胺組選用甲鈷胺針劑500 μg(日本衛材株會社生產,批號:120476),肌肉註射,隔天1次,共8週,而對照組不進行其他治療.採用酶免疫化學髮光分析法測定血漿Hcy水平,應用癥狀自評量錶SCL-90分析患者抑鬱、焦慮和生活能力等方麵的改善情況. 結果 對照組治療前後血漿Hcy水平分彆為(21.86±4.76)μmol/L和(18.67±3.81)μmol/L(t=0.40,P＞0.05),甲鈷胺組患者治療4週後血漿Hcy水平為(11.66±3.28) μmol/L,較治療前(22.68±5.16) μmol/L明顯下降(t=2.55,P＜0.01),與對照組治療後比較差異也有統計學意義(t=7.40,P＜0.01).甲鈷胺組治療後SCL-90總分、暘性項目、暘性總分和暘性均分均顯著優于治療前(t=2.04、2.97、5.45、4.21,均P＜0.05),與對照組治療後比較差異也有統計學意義(t=7.40、7.58、12.78、4.15,均P＜0.05),對照組治療前後比較差異均無統計學意義(均P＞0.05).甲鈷胺組治療前後在軀體化、人際關繫、抑鬱、焦慮、恐怖及其他方麵得分均高于治療前(t=2.34、2.28、2.51、2.19、3.40、2.35,均P＜0.05)；與對照組治療後在軀體化、人際關繫、抑鬱、焦慮、恐怖及其他方麵得分比較差異也有統計學意義(t=4.10、5.04、5.12、4.18、5.48、5.20,均P＜0.05),而治療前後偏執方麵得分差異無統計學意義(t=1.40,P＞0.05),治療組與對照組偏執方麵得分差異無統計學意義(t=1.48,P＞0.05),對照組治療前後比較差異均無統計學意義(均P＜0.05). 結論 甲鈷胺能有效降低急性腦梗死伴高Hcy血癥患者血漿Hcy水平,對患者焦慮、抑鬱、緊張等情緒有緩解作用.
목적 탐토갑고알대뇌경사반고동형반광안산(Hcy)혈증적치료작용급대뇌경사환자회복기정서장애적료효. 방법 수집2010년1월지2011년12월재아원신경내과주원적급성뇌경사반고Hcy혈증환자160례,병수궤분성갑고알조화대조조각80례,량조제진행급성뇌경사치료적상규처리외,갑고알조선용갑고알침제500 μg(일본위재주회사생산,비호:120476),기육주사,격천1차,공8주,이대조조불진행기타치료.채용매면역화학발광분석법측정혈장Hcy수평,응용증상자평량표SCL-90분석환자억욱、초필화생활능력등방면적개선정황. 결과 대조조치료전후혈장Hcy수평분별위(21.86±4.76)μmol/L화(18.67±3.81)μmol/L(t=0.40,P＞0.05),갑고알조환자치료4주후혈장Hcy수평위(11.66±3.28) μmol/L,교치료전(22.68±5.16) μmol/L명현하강(t=2.55,P＜0.01),여대조조치료후비교차이야유통계학의의(t=7.40,P＜0.01).갑고알조치료후SCL-90총분、양성항목、양성총분화양성균분균현저우우치료전(t=2.04、2.97、5.45、4.21,균P＜0.05),여대조조치료후비교차이야유통계학의의(t=7.40、7.58、12.78、4.15,균P＜0.05),대조조치료전후비교차이균무통계학의의(균P＞0.05).갑고알조치료전후재구체화、인제관계、억욱、초필、공포급기타방면득분균고우치료전(t=2.34、2.28、2.51、2.19、3.40、2.35,균P＜0.05)；여대조조치료후재구체화、인제관계、억욱、초필、공포급기타방면득분비교차이야유통계학의의(t=4.10、5.04、5.12、4.18、5.48、5.20,균P＜0.05),이치료전후편집방면득분차이무통계학의의(t=1.40,P＞0.05),치료조여대조조편집방면득분차이무통계학의의(t=1.48,P＞0.05),대조조치료전후비교차이균무통계학의의(균P＜0.05). 결론 갑고알능유효강저급성뇌경사반고Hcy혈증환자혈장Hcy수평,대환자초필、억욱、긴장등정서유완해작용.
Objective To study the effect of mecobalamine treatment on acute cerebral infarction combined with high homocysteine (Hcy) and post-stroke depression.Methods A total of 160 cerebral infarction patients with high Hcy were collected from January 2010 to December 2011 in our hospital.Patients were randomly divided into two groups:the control group (n=80,with routine therapy) and the treatment group (n=80,with routine therapy plus intramuscular injection with folic acid 500μg for 8 weeks).The plasma concentration of Hcy was determined by fluoresene polarization immunoassay.The improvement of depression,anxiety and life skills in patients were assessed by selfmade questionnaires and self-reporting inventory (SLC 90).Results There were no significant differences in plasma Hcy level in control group before versus after treatment [(21.86±4.76) μmol/L vs.(18.67±3.81) μmol/L,t=0.40,P＞0.05].Compared with before treatment,plasma Hcy level in treatment group was significantly reduced 4 weeks after treatment [(11.66 ± 3.28) μmol/L vs.(22.68±5.16) μmol/L,t=2.55,P＜0.01].There was a significant difference in plasma Hcy level between the treatment group and the control group after treatment [(11.66 ±3.28) μmol/L vs.(18.67±3.81) μmol/L,t=7.40,P＜0.01].TheSCL-90 total score,positive symptom items score,the total score and the average score of positive symptom items were significantly lower in treatment group after treatment than in treatment group before treatment (t=2.04,2.97,5.45,4.21,all P＜0.05) and in control group after treatment (t 7.40,7.58,12.78,4.15,all P＜0.05).The improvement on symptomatic patterns including somatization,obsessive-compulsive problems,interpersonal sensitivity,depression,anxiety and fear were better in treatment group after treatment than in treatment group before treatment (t 2.34,2.28,2.51,2.19,3.40,2.35,allP＜0.05) and in control group after treatment (t=4.10,5.04,5.12,4.18,5.48,5.20,all P＜0.05).There were no significant differences in the improvement in paranoid ideation between the treatment group before and after treatment (t=1.40,P＞0.05),between the treatment group and the control group after treatment (t=1.48,P＞0.05),and between the control group before and after treatment (P＞0.05).Conclusions Mecobalamine can effectively reduce plasma Hcy level in cerebral infarction patients with high plasma Hcy,and alleviate the symptoms of anxiety,depression,nervousness and other emotions.
