Effect of folic acid on vascular endothelial function in elderly cerebral infarction patients with hyperhomocysteinemia / 中国脑血管病杂志

ABSTRACT

Objective Toinvestigatetheeffectoffolicacidonplasmahomocysteine(Hcy)levels and vascular endothelial function in elderly cerebral infarction patients with hyperhomocysteinemia. Methods Thisstudywasaprospectivecontrolledtrial.Atotalof112elderlylacunarinfarction patients with high hyperhomocysteinemia admitted to the Department of Neurology,Nanjing Municipal Government Hospital from November 2012 to October 2013 were enrolled. The patients were divided into two groups according to the method of random number table. The patients of both groups received the conventional drug treatment of ischemic stroke at the same time. Fifty-six patients were in group A,and they were treated with folic acid 20 mg,once a day;56 patients were in group B,and they did not treat with folic acid. The Hcy levels on admission and after 24 weeks treatment were measured. Brachial artery flow-mediated endothelium-dependent dilation (FMD)was measured by high resolution ultrasound,and nitric oxide (NO), nitricoxidesynthase(NOS),andendothelin(ET)weredetectedatthesametime.Results Twenty-four weeks after treatment,the plasma Hcy level in group A was significantly decreased as compared with prior treatment (12. 2 ± 4. 2 vs. 22. 6 ± 3. 7μmol/L;P<0. 05),moreover,it was lower than the level of group B at the same period (12. 2 ± 4. 2 vs. 21. 8 ± 4. 0μmol/L;P <0. 05 ). The FMD level of group A was significantly higher than that of prior treatment and group B (11. 2 ± 3. 6 vs. 9. 2 ± 3. 3,9. 3 ± 3. 3;P<0. 05). The NO and NOS levels of group A at 24 weeks after treatment were significantly higher than those of prior treatment and group B at the same period (76. 2 ± 9. 4 vs. 49. 2 ± 9. 0,50. 0 ± 9. 1μmol/L,47. 6 ± 9. 5 vs.38. 4 ± 7. 5,37. 8 ± 8. 8 kU/L;P<0.05). The ET level of group A was decreased as compared with that of prior treatment and group B at the same period (81. 3 ± 20. 5 vs. 105. 6 ± 25. 2,105. 3 ± 21. 8 ng/L;P<0.05).NoadversereactionwasfoundduringthetreatmentingroupA.Conclusion Alargerdoseof folic acid can significantly reduce the plasma Hcy level,decrease the FMD level,and ameliorate vascular endothelial function in elderly cerebral infarction patients with hyperhomocysteinemia.