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目的观察脑梗死后认知功能障碍与血浆同型半胱氨酸(Hcy)水平关系及叶酸联合甲钴胺的干预作用。方法血浆Hcy水平采用荧光偏振免疫分析法进行检测,比较脑梗死后认知功能障碍患者(n=78)和认知功能正常患者(n=82)的血浆Hcy水平;将脑梗死后认知功能障碍患者随机分为治疗组和对照组各39例,对照组给予常规治疗,治疗组在对照组常规治疗的基础上加用叶酸联合甲钴胺,检测记录Hcy水平及MMSE分值。结果脑梗死后认知功能障碍患者血浆Hcy水平为(24.61±4.27)μmol/L高于认知功能正常患者的(18.93±5.66)μmol/L;治疗后治疗组患者MMSE分值明显高于治疗前及对照组,其血浆Hcy水平明显低于治疗前及对照组;差异均有统计学意义(P<0.05)。对照组治疗前后的血浆Hcy水平和MMSE分值均无显著变化(P>0.05)。结论血浆Hcy水平的高低对脑梗死后认知功能障碍的发生和程度具有一定影响,叶酸联合甲钴胺对脑梗死后认知功能障碍患者认知能力的改善具有积极作用。
Objective To observe the relationship between cognitive dysfunction and plasma homocysteine (Hcy) level after cerebral infarction and the intervention of folic acid and mecobalamin. Methods Plasma Hcy levels were measured by fluorescence polarization immunoassay to compare plasma Hcy levels in patients with cognitive impairment (n = 78) and normal cognitive function (n = 82) after cerebral infarction. The changes of cognitive function The patients were randomly divided into treatment group and control group, with 39 cases in each group. The control group was given routine treatment. The treatment group was given folic acid combined with mecobalamin. The Hcy level and MMSE score were recorded and recorded. Results The plasma Hcy level in patients with cognitive impairment after cerebral infarction was (24.61 ± 4.27) μmol / L higher than that in normal cognitive function patients (18.93 ± 5.66) μmol / L; MMSE score was significantly higher in treatment group than in treatment group The levels of Hcy in plasma before and in the control group were significantly lower than those before treatment and in the control group (all P <0.05). There was no significant change in plasma Hcy level and MMSE score before and after treatment in control group (P> 0.05). Conclusions The plasma Hcy level has some effect on the occurrence and degree of cognitive dysfunction after cerebral infarction. Folic acid combined with mecobalamin has a positive effect on the improvement of cognitive ability in patients with cognitive impairment after cerebral infarction.