干预高同型半胱氨酸水平对脑梗死后病人认知功能的影响

目的:观察干预同型半胱氨酸(Hcy)水平对脑梗死后病人认知功能的影响.方法 :选择高Hcy伴认知功能障碍的住院脑梗死病人72例,随机分为对照组及观察组,各36例.对照组常规治疗,观察组在常规治疗的基础上口服甲钴胺片,每天3次,每次500 mg.于病人治疗前(入院次日)和治疗4周、3个月及6个月后,分别检测2组病人Hcy水平,并应用简易智能精神状态检查量表(MMSE)和Barthel指数(BI)评价病人认知功能.结果 :治疗4周、3个月及6个月后,对照组Hcy水平与治疗前差异均无统计学意义(P>0.05);而观察组Hcy水平均较治疗前显著下降(P<0.01),且均显著低于对照组同期水平(P<0.01).2组病人治疗前的MMSE和BI评分差异均无统计学意义(P>0.05).对照组治疗前后MMSE评分差异无统计学意义(P>0.05),治疗3、6个月后的BI评分则明显优于治疗前(P<0.01);而观察组治疗3、6个月后的MMSE和BI评分均较治疗前明显提高(P<0.01),且观察组治疗3个月后的BI和治疗6个月后的MMSE评分均显著低于对照组(P<0.01).结论 :降低Hcy水平有助于改善脑梗死病人认知功能障碍.

Effect of the intervening homocysteine on cognitive function in patients with cerebral infarction

Objective:To observe the effects of the intervening homocysteine(Hcy) on cognitive function in patients with cerebral infarction. Methods:Seventy-two cerebral infarction patients with high Hcy complicated with cognition impairment were randomly divided into the control group and observation group(36 cases each group). The control group was treated with the routine method,and the observation group was treated with 500 mg mexobalamin by oral,three times a day,based on routine treatment. Before treatment and 4 weeks,3 and 6 months after treatment,the levels of Hcy in two groups were detected,and the cognitive function in two groups was evaluated using Mini-mental state examination( MMSE) and Barthel index( BI) . Results:The difference of the level of Hcy in control group between before and after treatment was not statistically significant(P>0. 05). Compared with the control group,the level of Hcy in observation group after treatment significantly decreased(P<0. 01),and which was significantly lower than that in control group at the same time(P <0. 01). The differences of the MMSE and BI scores before treatment between two groups were not statistically significant(P >0. 05). The difference of the MMSE score in control group between before and after treatment was not statistically significant(P>0. 05),and the BI scores in control group 3 and 6 months after treatment were significantly better than those of before treatment(P<0. 01). Compared with before treatment,the scores of MMSE and BI in observation group 3 and 6 months after treatment significantly increased,and were significantly lower than those in control group(P<0. 01). Conclusions:The decreasement of the Hcy level can improve the cognitive function in patients with cerebral infarction.