[关键词]
[摘要]
目的: 明确B 族维生素及叶酸对降低hcy( hyperhomocysteinemia) 的作用，明确HHe( Hyperhomocysteinemia)
是脑卒中的一个重要独立危险因素，B 族维生素及叶酸是否对缺血性卒中复发干预有效。方法: 采用
随机双盲对照分析，治疗组及对照组各30 例，治疗组: 2． 5mg 叶酸、0． 5mg 甲钴胺、VitB 620mg 每日三次口服，连
续服用到终点( 2a) ; 对照组: 安慰剂，连续服用到终点。观察同型半胱氨酸值服药后变化情况，观察服用B 族维
生素及叶酸后脑卒中复发情况( 进行mRS 评定) 。结果: 高同型半胱氨酸血症病人服用B 族维生素及叶酸后
6mo、1a 后同型半胱氨酸值明显降低; HHe 所致脑卒中病人，服用B 族维生素及叶酸后1mo、6mo 卒中复发无明
显差异( P＞0． 05) ; 服用B 族维生素及叶酸后1a、2a 卒中复发有明显差异( P＜0． 05) ) ，治疗组卒中复发明显减
少; 服药后无不良反应发生。结论: 高同型半胱氨酸血症是脑卒中一个重要的独立危险因素，B 族维生素及叶酸
有效干预高同型半胱氨酸症所致脑卒中的复发及减少卒中发生，B 族维生素及叶酸应作为是缺血性脑血管病一
级、二级预防用药。
[Key word]
[Abstract]
Objective: To clarify the effects of B－family vitamins and folic acid on lowering hcy，
HHe being an important dangerous factor causing stroke，and whether B－family vitamins and folic acid
are effective in interventing the recurring of ischemic cerebrovascular disease． Methods: A randomized
double－blind controlled method is employed． There are 30 cases in both the controlled group and treatment
group． The treatment group patients take 2． 5mg folic acid，0 ． 5mg mecobalamine and 620mg
VitB，each P． O t． i． d lasting two years． The patients in the controlled group take placebo for two years．
Then we observe the homocysteine value changes after mecobalamine are taken，and observe the stroke
recurring demonstrations after the B－family vitamins and folic acid are taken( The mRS evaluation is
conducted) ． Results: The homocysteine values of hyperhomocysteinemia patients go dwon significantly
after they take B－family vitamins and folic acid after both six months and one year． The stroke recurring
of HHe－caused stroke patients show no significant difference( P＞0． 05) after they take B－family vita-
mins and folic acid after one month and six months． The recurring demonstrations show significant
differences( P＜0． 05) after they take continue to take the drugs till one year and two years． The treatment
group patients have significantly lower recurring cases，and there are no untoward reactions or
effects after the drugs are taken． Conclusions: Hyperhomocysteinemia is an important dangerous factor
in causing stroke． The B－family vitamins and folic acid can effectively reduce stroke and intervene the
recurring of stroke caused by hyperhomocysteinemia． The B－family vitamins and folic acid can be the
primary and secondary prevention medicine against ischemic cerebrovascular disease．
[中图分类号]
R743． 9
[基金项目]
收稿日期: 2013－09－11; 修回日期: 2013－11－05
基金项目: 内蒙古自然基金( 2011MS1102)
作者简介: 张哲林( 1973－) ，男，内蒙古医科大学附属医院副主任医师，在读医学博士。
通讯作者: 邓珍华，主任医师，E－mail:
zhenhuadeng666@163． com 内蒙古自治区人民医院， 010017
