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目的了解正常人颈动脉硬化患者及脑梗死患者血清同型半胱氨酸(serumtotalnomocysteine,tHcy)水平及给予叶酸和维生素B12治疗后血tHcy含量的变化。方法脑梗死组80例,男71例,女9例,年龄63～80岁,平均74岁,符合脑梗死的诊断标准,均在发病后2周内测定tHcy含量;颈动脉硬化组80例,男71例,女9例,年龄62～79岁,平均72岁。双侧颈动脉B超检查均存在颈动脉硬化及(或)粥样斑块。以上两组均除外甲状腺功能减退及肾功能减退。入选者在测定血清叶酸、维生素B12、肌酐、血糖、血脂水平及血压和体重指数后,各组均随机分为两组,即干预治疗组及非干预治疗组,每组40例。干预治疗组患者给予叶酸1.25mg,隔日1次,维生素B128μg,1次/d,口服10个月后复查上述各项指标。结果治疗前3组血tHcy水平各不相同,脑梗死组为(16±5)μmol/L,颈动脉硬化组为(14±5)μmol/L,正常老年人组为(12±3)μmol/L,3组比较差异有显著意义。血tHcy含量增高,叶酸水平越低。相关分析发现,血tHcy水平与叶酸、维生素B12呈负相关。干预治疗后,治疗组患者的血tHcy含量均有所下降。结论不同程度的脑缺血性疾病与血tHcy水平有一定的关系,补充营养元素有助于降低血tHcy水平,以减少高tHcy对血管的素性作用。
Objective To investigate the changes of serum homocysteine (tHcy) levels and blood tHcy levels in patients with carotid atherosclerosis and cerebral infarction and the treatment with folic acid and vitamin B12. Methods 80 cases of cerebral infarction group, 71 males and 9 females, aged 63 to 80 years old, average 74 years old, in line with the diagnostic criteria of cerebral infarction, were measured within 2 weeks after onset of tHcy content; 80 cases of carotid atherosclerosis, 71 males and 9 females, aged 62 to 79 years, mean 72 years. Bilateral carotid artery B ultrasound examination of both carotid atherosclerosis and (or) plaque. Except the above two groups, both hypothyroidism and renal dysfunction. Participants in the determination of serum folate, vitamin B12, creatinine, blood glucose, blood lipid and blood pressure and body mass index, the groups were randomly divided into two groups, intervention and non-intervention groups, 40 cases. Intervention group patients were given folic acid 1.25mg, every other day, vitamin B128μg, 1 / d, 10 months after oral review of the above indicators. Results The levels of tHcy in the three groups before treatment were all different, with (16 ± 5) μmol / L in cerebral infarction group, (14 ± 5) μmol / L in carotid atherosclerosis group and (12 ± 3) μmol in normal elderly group / L, 3 groups were significant differences. Blood tHcy levels increased, the lower the level of folic acid. Correlation analysis found that blood tHcy levels and folic acid, vitamin B12 was negatively correlated. Intervention after treatment, the treatment group patients with blood tHcy levels have decreased. Conclusion Different degrees of cerebral ischemic disease and blood tHcy levels have a certain relationship, nutritional supplements can help reduce the level of blood tHcy, in order to reduce the high tHcy vascular effects.