摘要
目的观察急性脑梗死患者血管内皮功能、同型半胱氨酸(Hcy)水平变化,探讨叶酸、维生素B12的治疗作用。方法选择我院2011年1月—2012年10月收治的急性脑梗死患者160例,按是否合并高血压分为脑梗死合并高血压组80例和脑梗死未合并高血压组80例,再采用随机数字表将脑梗死未合并高血压组80例患者分为干预Ⅰ组和非干预Ⅰ组,每组40例;将脑梗死合并高血压组80例患者分为干预Ⅱ组和非干预Ⅱ组,每组40例;选择同期在我院健康体检中心体检健康者80例为对照组。采用彩色超声诊断仪测定肱动脉内径及颈动脉内膜中层厚度(IMT),计算反应性充血后血管内径变化率(FMD);循环酶法测定血清同型半胱氨酸(Hcy)水平;硝酸还原酶法测定血清一氧化氮(NO)水平、酶联免疫吸附试验(ELISA)测定血清内皮型NO合成酶(eNOS)水平。采用美国国立卫生研究院卒中量表(NIHSS)评价干预组治疗前后神经功能缺损程度,采用Barthel指数(BI)评价干预组治疗前后日常生活能力。结果脑梗死合并高血压组和脑梗死未合并高血压组FMD及血清NO、eNOS水平低于对照组(P<0.01),且脑梗死合并高血压组低于脑梗死未合并高血压组(P<0.01);脑梗死合并高血压组和脑梗死未合并高血压组IMT及血清Hcy水平高于对照组(P<0.01),且脑梗死合并高血压组高于脑梗死未合并高血压组(P<0.01)。干预Ⅰ组治疗2周后BI评分及血清NO、eNOS水平高于非干预Ⅰ组,NIHSS评分低于非干预Ⅰ组(P<0.01);干预Ⅰ组治疗12周后BI评分及血清NO、eNOS水平高于非干预Ⅰ组,NIHSS评分及血清Hcy水平低于非干预Ⅰ组(P<0.01)。干预Ⅱ组治疗2周后、治疗12周后BI评分及血清NO、eNOS水平高于非干预Ⅱ组,NIHSS评分及血清Hcy水平低于非干预Ⅱ组(P<0.01)。Spearman等级相关性分析结果显示,脑梗死合并高血压组和脑梗死未合并高血压组患者血清NO水平与血清Hcy水平均呈负相关(r值�
Objective To evaluate the vascular endothelial function and homocysteine （Hcy） level in patients with actue cerebral infarction, and explore the effects of folic acid, Vitamin B12 on the prognosis of acute cerebral infarction. Meth- otis A total of 160 patients with acute cerebral infarction treated in our hospital from January 2011 to October 2012 were included in this study. The patients were divided into two groups based on their blood pressure, namely the Group I of 80 patients with normal blood pressure and Group II of 80 patients with hypertension. Each group was divided randomly into two subgroups of 40 patients, namely Group I with intervention, Group I without intervention, Group lI with intervention, and Group 11 without intervention. And 80 healthy people who came to our hospital for regular physical examination during the same period were recrui- ted as the control group. The inner diameter of brachial artery, carotid intima- media thickness （IMT） were detected by Color Doppler, and brachial artery flow -mediated dilation （FMD） calculated; Serum Hcy level was determined by enzymatic cycling assay, serum nitrogen oxide （NO） by nitrate reductase method, and the serum level of endothelial nitrogen oxide synthase （eNOS） was measured by enzyme -linked immunosorbent assay （ELISA）. The degree of neurological deficits was evaluated by the National Institutes of Health Stroke Scale （NIHSS） of the U. S. , and the ability of daily living was rated with Barthel Index （BI）. Results The FMD, levels of NO, eNOS were lower in Group I with hypertension than those in Group H with normal blood pressure, all of which were lower than those in control group. The levels of Hcy and IMT were higher in Group I with hy- pertension than those in Group II with normal blood pressure, all of which were higher than those in control group. The compari- son among the four test subgroups showed that, compared to the two subgroups without intervention, the two subgroups with inter- vention has higher leve
出处
《中国全科医学》
CAS
CSCD
北大核心
2013年第26期3057-3061,共5页
Chinese General Practice
基金
江西省科技计划项目(20122BBG70146)
关键词
脑梗死
血管内皮
半胱氨酸
叶酸
维生素B12
Brain infarction
Endothelialium vascular
Cysteine
Folic acid
Vitamin B12
