摘要
目的探讨不同剂量B族维生素对高同型半胱氨酸血症(hyperho mocysteinemia,Hhcy)脑梗死患者二级预防的作用。方法采用随机对照法,将900例Hhcy脑梗死患者分为大剂量B族维生素干预组300例(口服叶酸25 mg,甲钴胺500μg,维生素B630 mg,均为2次/d),小剂量B族维生素干预组300例(口服叶酸2.5 mg,甲钴胺500μg,维生素B630 mg,均为1次/d)和对照组300例,随访1年,观察不同剂量B族维生素联合应用对脑梗死症状性复发与影像学再发的二级预防作用,记录试验期间血浆总同型半胱氨酸(total homocysteine,tHcy)水平。结果B族维生素干预可显著降低患者血浆tHcy水平,且大剂量B族维生素干预组比小剂量B族维生素干预组更明显,但对脑梗死症状性复发和影像学再发大剂量B族维生素干预组和小剂量B族维生素干预组均无明显降低。结论 B族维生素可降低Hhcy脑梗死患者的血浆tHcy水平,但未能证实B族维生素干预对Hhcy脑梗死患者二级预防有益。
Objective To investigate effect of vitamin B therapy on recurrent stroke in patients with ischemic stroke and hyperhomocysteinemia（Hhey）. Methods A randomized control study was carried out in 900 ischemic stroke with Hhey. They were assigned to large dose of B vitamins treatment group （folic acid 2.5 mg,bid,Bl2 500 μg,bid,B6 30 mg,bid, n =300）,small dose of B vitamins treatment group （folic acid 2.5 mg,qd,Bl2 500 p.g,qd,B6 30 mg,qd,n =300） and control group （ not administrated with VB, n = 300）. The follow up was 1 year. The effects of different dose of B vitamins on the recurrent stroke were recorded. Total homocysteine （they） level were detected during the treatment. Results B vitamins intervention can significantly reduce plasma tHey level in patients with isehemic stroke, and more obviously in the large dose of B vitamins treatment group. Both large and small dose B vitamins treatment cannot significantly reduce the recurrent rate of cerebral infarction or improve the radiographic manifestation of infarct area. Conclusion B vitamins treatment can decrease the serum level of tHcy in patients with ischemic stroke and hyperhomocysteinemia, but has not certain prevention for the recurrent stroke.
出处
《中华全科医学》
2014年第6期917-919,共3页
Chinese Journal of General Practice
