不同剂量叶酸联合维生素B12干预对高Hcy急性心肌梗死患者预后的影响

目的：探讨不同剂量叶酸联合维生素B12干预对高同型半胱氨酸（HHcy）急性心肌梗死患者预后的影响。方法：445例HHcy急性心肌梗死患者按照治疗方法分为观察组（n=223）和对照组（n=222）。比较两组患者治疗前后血清Hcy水平，分析影响HHcy心肌梗死患者发生主要不良心血管事件（MACE）的相关因素。结果：治疗后两组患者血清Hcy水平均下降，观察组下降幅度高于对照组（P<0.05）。治疗后观察组2a MACE发生率明显低于对照组（9.87%vs 21.62%，P<0.05）。Cox单因素及多因素分析显示年龄、糖尿病、LDL-C、Hcy、治疗方式与HHcy急性心肌梗死患者治疗后发生MACE密切相关。结论：叶酸联合维生素B12干预能够降低HHcy急性心肌梗死患者MACE的发生率，且叶酸剂量15 mg·d^-1效果最佳。

Effect of different doses of folic acid combined with vitamin B12 on prognosis of patients with high Hcy acute myocardial infarction

OBJECTIVE To investigate the effect of different doses of folic acid combined with vitamin B12 on the prognosis of patients with high Hcy acute myocardial infarction. METHODS 445 patients with high Hcy acute myocardial infarction were divided into observation group(n=223) and control group(n=222) according to the treatment method. The serum levels of Hcy were compared between the two groups before and after treatment, and the related factors affecting major adverse cardiovascular events(MACE) in patients with high Hcy myocardial infarction were analyzed. RESULTS After treatment, the levels of serum Hcy in both groups decreased, and the decrease in the observation group was higher than that in the control group(P<0.05). After treatment, the incidence of MACE in observation group was significantly lower than that in control group(9.87% vs 21.62%, P<0.05). Cox univariate and multivariate analysis showed that age, diabetes mellitus, LDL-C, Hcy, treatment methods were closely related to MACE after treatment in patients with high Hcy acute myocardial infarction. CONCLUSION Folic acid combined with vitamin B12 intervention can reduce the incidence of MACE in patients with high Hcy acute myocardial infarction, and folic acid dosage of 15 mg·d^-1 showed optimum effect.