叶酸联合维生素 B12 对高同型半胱氨酸脑梗死患者 DVT 的影响。

Effects of folic acid combined with vitamin B12 on DVT in patients with homocysteine cerebral infarction.

机构信息

The Department of Interventional Radiology of 1st Hospital of Lanzhou University, Lanzhou, Gansu, China.

出版信息

Eur Rev Med Pharmacol Sci. 2017 May;21(10):2538-2544.

Abstract

OBJECTIVE

To investigate the effects of folic acid combined with vitamin B12 on deep vein thrombosis (DVT) in patients with homocysteine cerebral infarction.

PATIENTS AND METHODS

90 patients with homocysteine cerebral infarction with DVT that were admitted to our hospital from January to July 2015 were selected as study subjects. They were divided into 2 groups randomly, the treatment group (n=45) and the non-treatment group (n=45). The treatment group was administered folic acid and vitamin B12, while the non-treatment group wasn't administered folic acid and vitamin B12. We compared and analyzed the levels of Hcy, folic acid and vitamin B12 of both groups. We investigated the correlation between the groups of patients with Hcy and folic acid and vitamin B12 treatment. We performed a comparative analysis of both groups of patients with an anticoagulant international normalized ratio (INR). The INR was recorded in detail for the first time as standard time, stable value time, obtain stable INR value time, activated partial thromboplastin time (APTT) and Prothrombin Time (PT) by color Doppler ultrasound observation of both groups with recurrent thrombosis.

RESULTS

We compared results of the intervention and treatment groups, and the prognosis of Hcy decreased significantly (p<0.05). While in the treatment group, folic acid and vitamin B12 levels increased significantly (p<0.05), the non-treatment difference of Hcy, folic acid, and vitamin B12 levels, before and after the patients in the intervention group, were not statistically significant (p>0.05). In the treatment group, Hcy was negatively correlated with folic acid (r=-0.376, p<0.05) while the Hcy of the treatment group was negatively correlated with vitamin B12 (r=-0.583, p<0.05). The intervention treatment group INR first standard time, stable value time and stable INR values were higher than those of non-treatment group (p<0.05). The treatment group APTT average was lower than in the non-treatment group (p<0.05). The average Pt in the treatment group was lower than non-treatment group (p<0.05). In the treatment group, lower limb deep static vein thrombosis recurrence rate was 4.4%, which was lower than the non-treatment group where the lower limb deep vein thrombosis recurrence rate was 28.9% (p<0.05).

CONCLUSIONS

Hcy is negatively correlated to folic acid and vitamin B12. Folic acid and vitamin B12 can reduce the recurrence rate of thrombosis in patients with lower extremity deep venous thrombosis in patients with Hcy disease. The mechanism of action may be to prevent the recurrence of thrombosis by reducing the levels of Hcy.

摘要

目的

探讨叶酸联合维生素 B12 对高同型半胱氨酸脑梗死合并深静脉血栓（DVT）患者的影响。

方法

选取我院 2015 年 1 月至 7 月收治的 90 例高同型半胱氨酸脑梗死合并 DVT 患者为研究对象，随机分为观察组（n=45）和对照组（n=45）。观察组给予叶酸、维生素 B12 治疗，对照组不给予叶酸、维生素 B12 治疗。比较并分析两组患者 Hcy、叶酸、维生素 B12 水平，分析观察组患者 Hcy 与叶酸、维生素 B12 治疗的相关性，比较两组患者抗凝国际标准化比值（INR），采用彩色多普勒超声观察两组患者的复发性血栓，详细记录首次 INR 标准时间、稳定值时间、获得稳定 INR 值时间、活化部分凝血活酶时间（APTT）和凝血酶原时间（PT）。

结果

观察组干预治疗后 Hcy 水平明显降低（p<0.05），观察组叶酸、维生素 B12 水平明显升高（p<0.05）；对照组患者 Hcy、叶酸、维生素 B12 水平治疗前后差异无统计学意义（p>0.05）。观察组 Hcy 与叶酸呈负相关（r=-0.376，p<0.05），Hcy 与维生素 B12 呈负相关（r=-0.583，p<0.05）。观察组 INR 首次标准时间、稳定值时间及稳定 INR 值均高于对照组（p<0.05），观察组 APTT 平均值低于对照组（p<0.05），观察组 Pt 平均值低于对照组（p<0.05）。观察组下肢深静脉血栓复发率为 4.4%，低于对照组的 28.9%（p<0.05）。