Effect of folic acid and vitamin B12 on the plasma homocysteine levels and neurological function in young and middle-aged acute ischemic stroke patients with hyperhomocysteinemia / 国际脑血管病杂志

ABSTRACT

Objective To investigate folic acid and vitamin B12 on the plasma homocysteine (Hcy) levels and neurological function in young and middle-aged acute ischemic stroke patients with hyperhomocysteinemia (HHcy).Methods Young and middle-aged acute ischemic stroke patients with HHcy were enrolled.They were randomly divided into either an intervention group or a control group.The patients with cerebral infarction in both groups were treated with conventional treatment.At the same time,the patients in the intervention group were treated with folic acid 5 mg and vitamin B12 25 μg,3 times a day for 4 weeks.Those in the control group were given placebo.The next day after admission and thereafter,the plasma Hcy levels were determined once every week.At the time of admission and after 4-week treatment,the National Institutes of Health Stroke Scale (NIHSS) was used to evaluate neurological deficits.Results A total of 78young and middle-aged acute lschemic stroke patients with HHcy were enrolled (n =39 in each group).The baseline plasma Hcy levels and the NIHSS scores in all patients had significant linear correlation (r =0.717;P＜0.01).Four weeks after treatment,the plasma Hcy levels of the intervention group were significantly lower than those of the control group (15.07 ± 2.01μmol/L vs.21.29 ± 2.48 μmol/L; t =4.539; P ＜0.05),but there was no significant difference in the NIHSS scores (4.87 ± 2.17 vs.5.13 ± 1.67; t =0.585,P =0.560).Conclusions The baseline plasma Hcy level was positively correlated with the severity of stroke.Folic acid in combination with vitamin B12 could effectively decrease the plasma Hey level in young and middle-aged acute ischemic stroke patients with HHcy,but it had no significant effect on the improvement of neurological function.