中文摘要：

目的：探讨叶酸和复合维生素B（VitB）对血浆同型半胱氨酸（Hey）及脑卒中的作用。方法：134例脑卒中患者依随机数字表法分为叶酸和复合VitB治疗的干预组和常规治疗的对照组各67例，分别检测各组患者入院和出院时血浆Hcy、D-二聚体（D—D）、纤维蛋白原（FIB）、三酰甘油（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL—c）和低密度脂蛋白胆固醇（LDL—c）水平，观察干预效果。随访12个月，运用脑卒中残损评定法（SIAS）进行评价，确定患者预后情况。结果：干预后干预组血浆Hcy水平为（13．59±3．84）μmol／L，对照组为（14．78±4．32）μmol／L，均较干预前有所下降，差异有统计学意义（均P〈0．01）。干预组D—D、TC、TG、LDL—C和FIB水平治疗后均下降，治疗效果优于对照组，差异有统计学意义（P〈0．05或P〈0．01）。干预组脑卒中患者复发率（22．4％）低于对照组（44．1％）。前者SIAS评分为（20．72±2．33）分，明显高于后者的（12．70±1．77）分，差异有统计学意义（P〈0．01）。结论：补充叶酸和复合VitB可降低血浆Hcy水平，对预防和治疗脑卒中具有重要意义。

英文摘要：

Objective： To study the effect of folic acid and compound vitamin B （VitB） on plasma homocysteine （Hey） level and in patients with stroke. Methods： One hundred and thirty-four patients with stroke were randomly assigned to folic acid and compound Vit B intervention group （n=67） and routine therapy group （control, n=67）. The plasma levels of Hcy, D-dimer （D-D）, fibrinogen （FIB）, triglyceride （TG）, total cholesterol （TC）, high density lipoprotein cholesterol （HDL-C）and low-density lipoprotein cholesterol （LDL-C） were measured to observe intervention effects at admission and discharge. After 12-month follow-up, all patients were evaluated by the stroke impairment assessment method （SIAS） to determine the prognosis. Results： After adding the folic acid and compound Vit B, the level of plasma Hcy was significantly lower in both groups [（13.59±3.84） μmol/L and （14.78±4.32） μmol/L] than that before the treatment （P 〈 0.05）. Levels of D-D, TC, TG, LDL-C and FIB reduced significantly in intervention group, and the therapeutic effect was significantly better in the intervention group than that in control group （P 〈 0.05 or P 〈 0.01）. The rate of stroke recurrence was significantly lower in intervention group （22.4%） than that of control group （44.1%, P = 0.021）. The SIAS score was significantly higher in intervention group （20.72±2.33） than that of control group （12.70±1.77, P 〈 0.01）. Conclusion： Folic acid and compound Vit B can reduce the plasma Hcy level, which plays a key role to prevent and treat for stroke.