叶酸和甲钴胺联合治疗血管性痴呆患者高同型半胱氨酸血症

目的探讨血管性痴呆（VD）病人血浆同型半胱氨酸（Hcy）水平的变化及叶酸和甲钴胺干预治疗对VD病人血浆Hcy水平的影响。方法选取85例VD病人为病例组,81例同龄非痴呆老人为对照组,测定2组血浆中Hcy、叶酸、维生素B12水平,并随机选取20例VD病人接受口服叶酸5 mg及肌内注射甲钴胺500μg,每日1次,干预治疗4周。结果VD病人血浆中Hcy水平显著高于对照组（P〈0.01）,血浆中叶酸水平、维生素B12显著低于对照组（P〈0.01）,接受叶酸和甲钴胺干预治疗的20例VD病人,4周后血浆中Hcy水平下降（P〈0.01）,叶酸及维生素B12水平均升高（P〈0.01）。结论VD病人血浆中Hcy水平高;使用叶酸和甲钴胺干预治疗能够有效地降低VD病人血浆中Hcy水平。

Effect of Folic Acid Combined with Mecobalamin on Vascular Dementia Patients with Hyperhomocysteinemia

Objective ] To explore the level changes of homocysteine （ Hcy ） of patients with vascular dementia （ VD ） and the effects of the treatment with folic acid and mecobalamine on the plasma level of VD patients＇ Hcy. Methods ] 85 VD patients were selected as case group, 81 same aged people without dementia were selected as control group. Levels of plasma Hcy, folic acid and Vitamin B12of each group were detected respectively. 20 VD patients were selected randomly to take folic acid 5mg per day and to be injected intramuscularly with mecobalamine 500μg per day for 4 weeks. Results] The level of plasma Hcy in VD group was significantly higher than that of control group（ P 〈0. 01 ）. The levels of plasma folic acid and Vitamin B12 in VD group were significantly lower than that of control group（ P 〈0. 01 ）. After receiving folic acid and mecobalamine treatment for 4 weeks, the level of plasma Hcy of 20 VD patients declined（ P 〈 0. 01 ）, and the levels of plasma folic acid and Vitamin B12 increased （ P 〈 0. 01 ）. Conclusion] The level of plasma Hcy of VD patients is high. The treatment with folic acid and mecobalamine can effectively decrease the level of serum Hcy of VD patients.