姜爽 郑敏 孙亚男 朱兆武 刘伟娜

【摘要】 目的：探討叶酸联合维生素B6治疗缺血性脑卒中的效果及对血浆Hcy、D-二聚体及血脂水平的影响。方法：选取2019年1月-2020年3月98例缺血性脑卒中患者，根据随机数字表法分为对照组和观察组，每组49例。对照组给予常规治疗，观察组在对照组的基础上加用叶酸联合维生素B6治疗。比较两组治疗前和治疗后1周的血浆因子（血浆Hcy、D-二聚体、NSE）和血脂水平（甘油三酯、总胆固醇、高密度脂蛋白、低密度脂蛋白）及治疗1、3、7、14 d的NIHSS评分。结果：治疗前，两组血浆因子和血脂水平比较，差异均无统计学意义（P>0.05）;治疗后1周，两组血浆因子和血脂水平均低于治疗前，且观察组均低于对照组，差异均有统计学意义（P<0.05）。治疗前，两组神经功能缺损评分比较，差异无统计学意义（P>0.05）;治疗1、3、7、14 d，观察组神经功能缺损评分均低于对照组，差异均有统计学意义（P<0.05）。结论：叶酸联合维生素B6用于缺血性脑卒中的治疗中可降低患者血浆Hcy、D-二聚体、NSE水平，改善体内机体血脂水平，降低神经功能缺损评分，值得推广应用。

【关键词】 叶酸 维生素B6 缺血性脑卒中 Hcy D-二聚体 血脂水平

[Abstract] Objective： To investigate the effect of Folic Acid combined with Vitamin B6 in the treatment of ischemic stroke and its effect on plasma Hcy， D-dimer and blood lipid levels. Method： A total of 98 patients with ischemic stroke from January 2019 to March 2020 were selected， and they were divided into control group and observation group according to random number table， 49 cases in each group. The control group was given conventional treatment， and the observation group was treated with Folic Acid combined with Vitamin B6 on the basis of control group. Plasma factors （plasma Hcy， D-dimer， NSE） and blood lipid levels （triglyceride， total cholesterol， high-density lipoprotein cholesterol， low density lipoprotein cholesterol） before treatment and 1 week after treatment and NIHSS scores at 1， 3， 7 and 14 d after treatment were compared between two groups. Result： Before treatment， there were no significant differences in plasma factor and blood lipid levels between two groups （P>0.05）， 1 week after treatment， plasma factors and blood lipid levels were lower than those of before treatment， and observation group were lower than those of control group， the differences were statistically significant （P<0.05）. Before treatment， there was no significant difference in neurological function deficit scores between two groups （P>0.05）， 1， 3， 7 and 14 d after treatment， neurological function deficit scores of observation group were lower than those of control group， the differences were statistically significant （P<0.05）. Conclusion： Folic Acid combined with Vitamin B6 in the treatment of ischemic stroke can reduce the level of plasma Hcy， D-dimer and NSE， improve the blood lipid levels， and reduce the neurological function deficit scores， which is worthy of promotion and application.

[Key words] Folic Acid Vitamin B6 Ischemic stroke Hcy D-dimer Blood lipid levels

First-author’s address： Jiamusi Traditional Chinese Medicine Hospital， Jiamusi 154002， China

doi：10.3969/j.issn.1674-4985.2021.18.039

脑卒中在临床中又称为“中风”，是以脑组织缺血或出血引起的脑供血不足为特征的急性脑血管疾病，主要有缺血性和出血性两种形式，有起病急和病情重的特点，不仅导致肢体残疾，还会造成认知功能障碍，严重影响生活质量[1]。发病因素主要有可干预和不可干预的危险因素两大类。不可干预因素有自身的遗传、年龄和性别等，可干预的危险因素包括生理病理学危险因素如Hcy、高血压病、心脏病、血脂异常、DM以及行为学因素，因此，需要对于脑卒中患者进行积极预防和有效干预来降低发病危险[2-3]。……