叶酸联合甲古胺对尿毒症患者血浆总同型半胱氨酸水平及颈动脉粥样硬化的影响

目的:观察叶酸联合甲古胺对尿毒症患者血浆总同型半胱氨酸(tHcy)水平及颈动脉粥样硬化的影响。方法:65例伴有颈动脉粥样硬化的尿毒症患者给予口服叶酸片和甲古胺片,6个月后观察其血浆tHcy水平、颈动脉内-中膜厚度(IMT)、颈动脉血流动力学参数、颈动脉粥样硬化斑块的数量和超声分型的变化。结果:治疗6个月后,患者血浆tHcy水平较治疗前显著下降(P<0.01),颈动脉IMT明显变薄(P<0.01),血流阻力指数(RI)显著下降(P<0.05),颈动脉粥样硬化斑块的超声分型也发生了变化,斑块数量减少具有统计学意义(P<0.05)。结论:叶酸联合甲古胺能显著降低尿毒症患者血浆tHcy水平,减少高Hcy对血管的毒性作用,有助于尿毒症患者颈动脉粥样硬化的疾病转归。

Effects of plasma total homocysteine and carotid atherosclerosis usingfolic acid in combination with mecobalamin in uremia patients

Objective:To observe the effect of plasma total homocysteine(tHcy) and carotid atherosclerosis using folic acid in combination with mecobalamin in uremia patients. Methods:65 cases of uremia patients with carotid atherosclerosis were treated with folic acid tablets and mecobalamin tablets for six months. The variations of tHcy levels, carotid intimia-media thickness (IMT) , hemodynamic parameters, numbers and ultrasound types of carotid atherosclerotic plaques before and after treatment were observed. Results: After six months, the levels of tHcy were decreased significantly (P < 0. 01 ) , carotid IMT became thinner significantly (P <0.01) ,and the resistance index (RI) was decreased significantly (P <0. 05). The ultrasound types of carotid atherosclerotic plaques have changed after six months, and the plaque numbers were decreased significantly ( P < 0. 05 ). Conclusions: The levels of tHcy were decreased significantly using folic acid in combination with mecobalamin in uremia patients, and maybe helpful to the progression of carotid atherosclerotic diseases.