| Objective: This paper is to investigate the function of folate and mecobalamin supplement for ①reducing plasma Hcy levels, enhancing the level of plasma folate and vitamin B12; ② the effect of folate and mecobalamin supplement on the clinical efficacy of youth acute cerebral infarction; ③the effect of folate and mecobalamin supplement on recurrence of cerebral infarction. Method: The method was to adopt randomized parallel-group analysis, select the 120 young patients meeting experimental conditions who got acute cerebral infarction with HHcy received in3 years from January 2010 to December 2012 and randomly divide them into experimental group and the control group, with 60 patients in each group. The baseline information of both groups has no significant differences. When the patients were admitted to hospital, their neurological deficits scores(NIHSS) were recorded and their fasting blood pumping plasma Hcy, folate and vitamin B12 levels are also tested. The treatment process was completely in accordance with the principles of acute cerebral infarction treatment in our hospital, and treatments of improving microcirculation, anti-platelet aggregation, anti-coagulation, brain protection, blood pressure control, blood sugar control, complications prevention, physical exercise, etc. were conducted based on the illness condition. Folate 5mg Tid, mecobalamin 0.5mg Tid took orally were added for the patients in the experimental group and after three months, the amounts were reduced to folate 5mg Qd and mecobalamin 0.5mg Qd, which were taken by the patients until the end(for 2 years). In the 3rd month and the 12 th month, the plasma Hcy, folate and vitamin B12 values were retested respectively and the neurological deficit scores were also recorded(conducting BI, mRS, NIHSS rating), and the changes of Hcy values after medication were observed; in addition, the clinical effects of taking folate and methylcobalamin on youth acute cerebral infarction were observed in the 3rd month and the 12 th month; the recurrence of cerebral infarction was observed after 2 years. Results: ①The comparison of plasma Hcy, folate, vitamin B12 values in the two groups: no difference in the plasma Hcy, folate and vitamin B12 values when the patients were admitted in hospital. After taking medicine for 3 months and 12 months, the Hcy value of the patients in the experimental group significantly decreased compared with that when they were admitted. The plasma folate, vitamin B12 values significantly increased, which had statistical significance(p <0.05); but the corresponding values of the patients in the control group had no significant change compared with that when they were admitted, which had no statistically significant(p> 0.05). In the 3rd month and the 12 th month, the contents of plasma folate and vitamin B12 in the experimental group were significantly higher than the control group, while the plasma Hcy value was significantly lower than that of the control group(p <0.05),which had statistical significance; ② Comparison of clinical efficacy: The clinical efficacy of the test group was better than that of the control group. For the experimental group, after taking medicine for 3 months, the patients with BI score of 95-100 points were 33(accounting for 55.0% in the total number), the patients with mRS score of 0-2 grades were 37(accounting for 61.7%), while the percentages of the control group were respectively 33.3% and 43.3%. For the experimental group, in the 12 th month, the patients with BI score of 95-100 points were 36(accounting for 60.0%), the patients with mRS score of 0-2 grades were 41(accounting for 68.3%), while the percentages of the control group were respectively 36.6% and 48.3%. And there were significant difference between the favorable prognosis rates of the two groups(p <0.05); ③ Comparison of NIHSS scores between the two groups: The NIHSS scores of both groups at were reduced in the two designated time point compared with those before treatment. The NIHSS score of the experimental group was 7.11 ± 1.16 in the 3rd month, and 2.65 ± 0.55 in the 12 th month; while the NIHSS score of the control group was respectively 10.86 ± 1.11 and 4.65 ± 1.51 in the 3rd and 12 th month. The difference of NIHSS scores of the two groups in the two time points had statistical significance(p <0.05); ④ Comparison of recurrence rate between the two groups: In the-year follow-up period, there were 4 cases of recurrence among the 60 patients of the experimental group, with the recurrence rate of 6.67%, and there were 9 cases of recurrence among the 60 patients of the control group, with the recurrence rate of 15.00%, The recurrence rate of cerebral infarction between the two groups had statistically significant(p <0.05); ⑤ There was no adverse reactions during the follow-up, and few patients wre found with slightly decrease of serum zinc, which was timely supplied. Conclusion: ① Hyperhomocysteinemia is a main independent risk factor for acute cerebral infarction in youth people, and also an independent risk factor for cerebral infarction recurrence; ② Supplements of folate and mecobalamin can effectively reduce plasma Hcy levels, increase plasma folate and vitamin B12 levels; ③Supplements of folate and mecobalamin can significantly improve the clinical efficacy, improve clinical outcomes and reduce the degree of disability; ④Supplements of folate and mecobalamin can significantly reduce the recurrence rate of cerebral infarction; ⑤Supplements of folate and mecobalamin are safe and reliable; ⑥ Folate and mecobalamin can be used for the treatment for young patients with acute cerebral infarction with Hhcy and also prophylaxis. |
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