| Objective To study effects of different doses of folic acid and vitamin B12 on high homocysteine with DVT in rabbits,then to effects of different doses of folic acid and vitamin B12 on high homocysteine with DVT recurrence in patients.Methods 1.63 New Zealand white rabbits were used to reproduce into the HHcy model with a diet containing 1% methionine,which were fed for 4 weeks.Fasting venous blood 3ml was taken at zeroth weeks,second weeks and fourth weeks after fasting for 12 hours,respectively.Serum homocysteine concentration(Homocysteine,Hcy)was detected.Second days of the fourth weeks,the DVT model of the femoral vein of left hind limbs of rabbit was constructed.Color Doppler ultrasound was used to observe the formation of thrombus.2.60 new zealand rabbits were randomly divided into model control group(20 rabbits,fed with normal feeds),low-dose group(20 rabbits,fed with Folic Acid Tablets 5 mg/d + vitamin B12 tablets 0.25 mg/d)and high dose group(20 rabbits,fed with Folic Acid Tablets 15mg/d+ vitamin B12 tablets 0.5 mg/d).Measured blood rheology,coagulation function,plasma Hcy,D-dimer changes and changes of rabbits of deep venous thrombosis of lower extremity histopathology was observed with optical microscope,color Doppler ultrasound observation of prognosis of thrombosis in each group.3.90 Patients with high homocysteine and DVT recurrence were divided into two groups randomly,treated patients(n =45)took folic acid and mcobalamin tablets for 3 months,the rest of patients(control group,n = 45)didn’t take folic acid and mcobalamin tablets,the serum levels of Hcy,folate,Vitamin B12,plaque scores and types of plaque were measured.To summarize its clinical features and distribution rules.Correlation analysis between Hcy and gender,age and serum index,the correlation between Hcy and folic acid and vitamin B12 level in two groups,and the correlation between Hcy and folic acid and vitamin B12 in treatment group were analyzed by themselves.The blood coagulation index of the two groups,including INR,APTT and PT,was analyzed and compared.The occurrence of two groups of thrombus recurrence was observed.Results : 1.after fourth weeks of feeding with 1% methionine in feed,the concentration of serum Hcy in 63 New Zealand white rabbits was(12.18 + 1.23)mol/l.After ligation,3 rabbits died,and the success rate of the DVT model of the left hind leg ligature of the 60 rabbits was 100%.Of these,9 had acute lower extremity DVT,and 51 had subacute or chronic lower extremity DVT.2.New Zealand white rabbits made 3 d after modeling and 10 d after modeling.There was a significant difference in hemorheology and coagulation function between the high-dose group and the low dose group compared with the model control group(P<0.05),and the high-dose group was significantly better than the low dose group(P<0.05).Before modeling,group three Hcy,two D-dimer level had no significant difference(P > 0.05),10 d after modeling,the high dose group and low dose group of Hcy,two D-dimer level compared with the model compared with the control group,the difference was statistically significant(P<0.05),and high dose group obviously low in low dose group,the difference was statistically significant(P<0.05).After modeling for 10 d,compared with the model control group,histopathological changes of deep venous thrombosis of rabbits in the high-dose group and low dose group were significantly relieved,while those in the high dose group were the best.After modeling 10 d,the effective rate of lower extremity deep venous thrombosis in high dose group was 100%,which was higher than that in low dose group and model control group(P < 0.05).3.The peak of the DVT incidence of male and female in this group are all 50-59 years old;The ratio of thrombosis in both lower limbs,right lower limbs and left lower limbs were 8.89%,25.56% and 65.55% respectively,and there were significant differences between each other(P<0.05);The constituent ratios of peripheral,central and mixed thrombosis were 24.07%,29.63% and 46.30%,respectively,There was no significant difference between the peripheral type and the central type(P>0.05),while the mixed type was statistically different from the peripheral type and the central type(P<0.05);All the patients were tested by Two-dimensional color Doppler flow imaging(CDFI)and venougraphy as well,CDFI is of significant diagnostic value in detecting the deep Venous thrombosis in the common femoral vein,superficical femoral vein,deep femoral vein,Popliteal femoral vein were involved frequently;There was no statistical difference in the distribution of sex,age,weight,Glu,BUN,TC,TG,Cr,TP,ALT,LDL-C,HDL-C,Lp(a),Apo AI,Apo B,thrombu s type and limb thrombus in the two groups(P>0.05);There was no significant difference in the level of serum Hcy between male and female patients(P>0.05);With the increase of the level of Hcy showed an increasing trend of age,Comparison of more than 60 years old group and the other two groups had significant difference(P<0.05);There was no correlation between serum Hcy levels and serum indexes(P = 0.05);compared with before intervention,the intervention treatment group Hcy decreased significantly(P < 0.05),while the treatment group,folic acid and vitamin B12 levels were significantly increased(P < 0.05)and non treatment group before and after the intervention of Hcy,folic acid,vitamin the level of B12 had no significant difference(P > 0.05);the treatment group of Hcy patients was negatively correlated with folic acid(r=-0.376,P<0.05);the patients in the treatment group Hcy and vitamin B12 were negatively correlated(r=-0.583,P<0.05);intervention treatment group INR first standard time,stable time,a stable INR value of time are better than non treatment group(P<0.05);the treatment group APTT and PT were lower than those of non treatment group(P<0.05);treatment group DVT recurrence rate is lower than the non treatment group(4.4% vs 28.9%,P < 0.05).Conclusion 1.methionine diet load replicated rabbit model of hyperhomocysteia,and the success rate was 100%.The formation rate of lower DVT was 100% after ligation of femoral vein,indicating that the rabbit model of Hcy with hyperhomocysteia was successfully established.2.folic acid and vitamin B12 can effectively treat DVT with hyperhomocysteinemia,and dose effect relationship is obvious.The two drugs can significantly reduce the level of plasma Hcy and D-two polymer,and significantly improve the degree of pathological changes of venous thrombosis of lower extremities.3.Hcy was negatively correlated with folic acid and vitamin B12.Folic acid and vitamin B12 can reduce the recurrence rate of thrombosis in patients with high Hcy and deep vein thrombosis.The mechanism may be to prevent thrombosis recurrence by reducing Hcy level. |
