ABSTRACT
Objective To study the effect of mecobalamine treatment on acute cerebral infarction combined with high homocysteine (Hcy) and post-stroke depression.Methods A total of 160 cerebral infarction patients with high Hcy were collected from January 2010 to December 2011 in our hospital.Patients were randomly divided into two groups:the control group (n=80,with routine therapy) and the treatment group (n=80,with routine therapy plus intramuscular injection with folic acid 500μg for 8 weeks).The plasma concentration of Hcy was determined by fluoresene polarization immunoassay.The improvement of depression,anxiety and life skills in patients were assessed by selfmade questionnaires and self-reporting inventory (SLC 90).Results There were no significant differences in plasma Hcy level in control group before versus after treatment [(21.86±4.76) μmol/L vs.(18.67±3.81) μmol/L,t=0.40,P＞0.05].Compared with before treatment,plasma Hcy level in treatment group was significantly reduced 4 weeks after treatment [(11.66 ± 3.28) μmol/L vs.(22.68±5.16) μmol/L,t=2.55,P＜0.01].There was a significant difference in plasma Hcy level between the treatment group and the control group after treatment [(11.66 ±3.28) μmol/L vs.(18.67±3.81) μmol/L,t=7.40,P＜0.01].TheSCL-90 total score,positive symptom items score,the total score and the average score of positive symptom items were significantly lower in treatment group after treatment than in treatment group before treatment (t=2.04,2.97,5.45,4.21,all P＜0.05) and in control group after treatment (t 7.40,7.58,12.78,4.15,all P＜0.05).The improvement on symptomatic patterns including somatization,obsessive-compulsive problems,interpersonal sensitivity,depression,anxiety and fear were better in treatment group after treatment than in treatment group before treatment (t 2.34,2.28,2.51,2.19,3.40,2.35,allP＜0.05) and in control group after treatment (t=4.10,5.04,5.12,4.18,5.48,5.20,all P＜0.05).There were no significant differences in the improvement in paranoid ideation between the treatment group before and after treatment (t=1.40,P＞0.05),between the treatment group and the control group after treatment (t=1.48,P＞0.05),and between the control group before and after treatment (P＞0.05).Conclusions Mecobalamine can effectively reduce plasma Hcy level in cerebral infarction patients with high plasma Hcy,and alleviate the symptoms of anxiety,depression,nervousness and other emotions.