摘要
目的观察叶酸联合甲钴胺治疗对脑小血管病(SVD)合并血浆高同型半胱氨酸血症(Hcy)患者认知功能的影响,探讨干预Hcy对血管性轻度认知功能障碍(VMCI)的改善作用。方法筛选84例SVD所致VMCI患者,患者同时合并Hcy,入选者均完善神经心理评估,并分为联合治疗组与常规治疗组,两组均接受常规治疗6个月,联合治疗组同时接受6个月的叶酸联合甲钴胺治疗,观察两组患者治疗前及治疗后3、6个月的Hcy水平、叶酸、维生素B12及阿尔茨海默病评价量表-认知分量表(ADAScog)评分变化。结果联合治疗组血浆Hcy随时间增加逐渐降低,而叶酸、维生素B12水平逐渐上升组内治疗3、6个月后,血浆Hcy、叶酸、维生素B12水平与治疗前及常规治疗组同时点比较差异均有统计学意义(P<0.01)。联合治疗组治疗后ADAS-cog评分较治疗前有所降低,3个月时组内比较差异无统计学意义(P>0.05),6个月时ADAS-cog评分组内比较差异有统计学意义(P<0.05)。常规治疗组治疗后ADAS-cog评分较治疗前有所升高,但3个月及6个月组内比较差异均无统计学意义(P>0.05)。联合治疗组与常规治疗组ADAS-cog评分在治疗3个月时差异无统计学意义(P>0.05),在治疗6个月时,差异有统计学意义(P<0.05)。结论叶酸联合甲钴胺治疗可降低血浆Hcy水平,干预Hcy对改善VMCI患者的认知功能可能有益。
Objective To observe the efficacy of folic acid combined with mecobalamine for the treatment of vascular mild cogni-tive impairment （VMCI） in patients with cerebral small vessel disease （SVD） and hyperhomocysteinemia（Hcy） .Methods A total of 84 VMCI patients with cerebral small vessel disease and Hcy were randomly divided into combination group and control group . Two groups received conventional therapy for 6 months .Besides ,the combination group received folic acid combined with mecobal-amin .The level of plasma Hcy and ADAS-cog score were observed before and after 3 months and 6 months treatment .Results Af-ter treatment ,plasma Hcy significantly lower in the combination group （P＆lt;0 .01） ,whereas it did not show any improvement in the control group .ADAS-cog scores in combination group decreased compared with that of before treatment ,but there was no statisti-cally significant difference after 3 months treatment（P＆gt;0 .05） .However ,after 6 months treatment ,the ADAS-cog scores decreased obviously than that in the before treatment group （P＆lt;0 .05） .ADAS-cog scores in control group increased compared with before treatment ,but there was no statistically significant difference in after treatment （P＆gt;0 .05） .After 3 months treatment ,there was no significant difference on ADAS-cog score between combination group and control group （P＆gt;0 .05） ,however ,there had significant difference between the two groups after 6 months treatment（P＆lt;0 .05） .Conclusion The level of plasma Hcy could be reduced by adding folic acid and mecobalamin .Treatment of hyperhomocysteinemia may delay the progression of vascular cognitive impairment w hich caused by cerebral small vessel disease .
出处
《重庆医学》
CAS
CSCD
北大核心
2014年第9期1055-1057,共3页
Chongqing medicine
基金
重庆市卫生局科技计划项目(2012-2-222)
关键词
血管疾病
血管性轻度认知损害
高同型半胱氨酸
叶酸
甲钴胺
vascular diseases
vascular mild cognitive impairment
hyperhomocysteine
folic acid
mecobalamin
