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目的研究血浆同型半胱氨酸血症(Hcy)与老年人缺血性脑卒中的关系;探讨老年缺血性脑卒中患者给予维生素B12制剂(甲钴胺)和叶酸治疗前后血浆同型半胱氨酸、叶酸和维生素B12水平变化及其对预后的影响。方法检测60例老年缺血性脑卒中患者和60例我院体检中心的健康老年人血浆同型半胱氨酸、叶酸、维生素B12水平;将老年缺血性脑卒中随机分为干预组和非干预组,干预组给予甲钴胺联合叶酸治疗,治疗4周后复测血浆同型半胱氨酸、叶酸和维生素B12水平。结果老年缺血性脑卒中和正常健康对照组之间血浆Hcy水平有显著差异,病例组高于对照组;干预组与非干预组之间血浆Hcy水平、叶酸和B12水平无显著性差异(P>0.05),予以补充叶酸和甲钴胺治疗后,干预组血浆Hcy水平明显下降,与非干预组相比有显著性差异(P<0.05)。结论高同型半胱氨酸血症是缺血性脑卒中的一个独立危险因素;老年缺血性脑卒中患者血浆Hcy水平升高,补充叶酸、B12制剂有助于降低血浆Hcy水平,有利于老年缺血性脑卒中转归。
Objective To study the relationship between plasma homocysteinemia (Hcy) and ischemic stroke in the elderly, and to investigate the effect of vitamin B12 (mecobalamin) and folic acid treatment on plasma homocysteine Changes of Acid, Folic Acid and Vitamin B12 Levels and Their Impact on Prognosis. Methods The levels of plasma homocysteine, folic acid and vitamin B12 were measured in 60 senile ischemic stroke patients and 60 normal elderly people in our hospital. The elderly ischemic stroke were randomly divided into intervention group and non-intervention group Group, intervention group were given mecobalamin combined with folic acid treatment, after 4 weeks of retest plasma homocysteine, folic acid and vitamin B12 levels. Results There was a significant difference in plasma Hcy levels between elderly and ischemic stroke patients and healthy controls, with a higher incidence of Hcy and a higher level of Bcl-2 in plasma between the intervention and non-intervention groups (P > 0.05). After the treatment with folic acid and mecobalamin, the level of Hcy in the intervention group decreased significantly, which was significantly different from the non-intervention group (P <0.05). Conclusions Hyperhomocysteinemia is an independent risk factor for ischemic stroke. Plasma Hcy levels are increased in elderly patients with ischemic stroke. Supplementation of folic acid and B12 preparations may decrease plasma Hcy level and be beneficial to the elderly Ischemic stroke outcome.