摘要
目的探讨叶酸、VitB_(12)对老年高同型半胱氨酸血症脑梗死伴颈动脉粥样硬化患者血清胱抑素C(Cys C)、同型半胱氨酸(Hcy)、超氧化物岐化酶(SOD)表达的影响。方法选择2015年2月~2016年2月上海中冶医院收治的老年高同型半胱氨酸血症脑梗死伴颈动脉粥样硬化的130例患者,采用简单随机化方法分为观察组和对照组,各65例。所有患者均给予颈动脉斑块厚度超声检查。对照组予阿托伐他汀钙片20 mg(1次/d)和阿司匹林肠溶片100 mg(1次/d)的常规治疗,观察组在常规治疗的基础上加用叶酸5 mg(1次/d)和VitB_(12)500μg(2次/d),住院及出院后共治疗6个月。分别在入院时、出院6个月后测定患者血清叶酸、VitB_(12)浓度以及Hcy、Cys C、SOD表达水平,并探讨其与颈动脉粥样硬化程度的关系。结果治疗前,两组患者血清Hcy、叶酸、VitB_(12)、Cys C、SOD水平、颈动脉粥样硬化斑块厚度比较差异均无统计学意义(P>0.05);治疗后,观察组血清Hcy、Cys C、颈动脉粥样硬化斑块厚度均低于对照组(P<0.05);治疗后,观察组患者血清叶酸、VitB_(12)、SOD水平均明显高于对照组(P<0.05);患者的颈动脉粥样硬化程度与血清Cys C表达水平呈正相关(r=0.637,P<0.05),与血清SOD表达水平呈负相关(r=-0.585,P<0.05);患者的血清Cys C水平与SOD水平呈负相关(r=-0.608,P<0.05)。结论血清Cys C、SOD参与了高同型半胱氨酸血症脑梗死伴颈动脉粥样硬化的发病过程;叶酸、VitB_(12)能有效改善老年高同型半胱氨酸血症脑梗死伴颈动脉粥样硬化患者的颈动脉粥样硬化程度,降低血清Hcy、Cys C水平,提高SOD水平。
Objective To explore the effects of folic acid and VitB_（12） in the expression of cystatin C（Cys C）, homocysteine（Hcy） and superoxide dismutase（SOD） in the elderly patients with hyperhomocysteinemia and cerebral infarction with carotid atherosclerosis. Methods A total of 130 elderly cerebral infarction patients with carotid atherosclerosis treated in Shanghai MCC Hospital from February 2015 to February 2016 were divided into observation group and control group by simple randomization method, with 65 cases in each group. All the patients accepted carotid plaque integral ultrasound examination. Control group was treated with Atorvastatin 20 mg qd, and Aspirin Enteric-coated Tablets100 mg qd. Based on the routine treatment, observation group was treated with folic acid 5 mg qd and VitB_（12）500 μg bid for 6 months. The levels of Hcy, folic acid, VitB_（12）, Cys C, SOD and carotid-atherosclerotic-plaque-scores were measured before treatment（baseline） and 6 months after hospital discharge. Results Before treatment, there was no statistically significant difference between the two groups in the levels of Hcy, folic acid, VitB_（12）, Cys C, SOD and carotidatherosclerotic-plaque-scores（P〈0.05）. After treatment, the levels of serum Hcy, Cys C, carotid atherosclerotic plaque scores of the observation group were lower than those in the control group（P〈0.05）; the levels of serum folic acid, VitB_（12）, SOD of the observation group were higher than those in the control group（P〈0.05）. There was positive correlation of carotid atherosclerosis with the Cys C（r = 0.637, P〈0.05） and negative correlation with the level of SOD（r =-0.585, P〈0.05）. The negative correlation also was found between the levels of SOD and Cys C（r =-0.608,P〈0.05）. Conclusion Serum Cys C and SOD take role in the pathogenesis of hyperhomocysteinemia and cerebral infarction with carotid atherosclerosis. Folic acid and VitB_（12） can improve the degree of elderly hyperhomocysteinemia and cerebral infarction with carotid atherosclerosis, reduce the levels of serum Hcy and Cys C, and improve the level of SOD.
作者
高逸之
董成林
左权
钱紫娟
李婉青
张慧
田晓利
李仁杰
GAO Yizhi;DONG Chenglin;ZUO Quan;QIAN Zijuan;LI Wanqing;ZHANG Hui;TIAN Xiaoli;LI Renjie(Clinical Laboratory,Shanghai MCC Hospital,Shanghai 200941,China;Department of Cardiology,Shanghai MCC Hospital,Shanghai 200941,China;Department of Function,Shanghai MCC Hospital,Shanghai 200941,China)
出处
《中国医药导报》
CAS
2018年第23期88-91,95,共5页
China Medical Herald
基金
国家高技术研究发展计划(863计划)资助项目(2014AA022304)
