中文摘要：

目的 研究叶酸联合维生素E治疗对缺血性脑卒中合并高同型半胱氨酸血症（h Hcy）患者预后的影响。方法选取2015年7月~2016年10月大同市第五人民医院神经内科收治的120例缺血性脑卒中合并h Hcy患者,按照区组随机化随机分为对照组、叶酸组、维生素E组及叶酸联合维生素E组,每组各30例。所有患者在治疗前及治疗后1个月和3个月化验血浆型半胱氨酸（Hcy）水平,在治疗前及治疗后第7天和1个月进行NIHSS评分,分析各组患者血浆Hcy水平及NIHSS评分的变化。结果 治疗后1个月及3个月,对照组及维生素E组患者血浆Hcy水平与治疗前比较,差异无统计学意义（P〉0.05）,而叶酸组及叶酸联合维生素E组患者血浆Hcy水平较治疗前明显降低（P〈0.05）。治疗后第7天及1个月,叶酸组较对照组患者NIHSS评分差异无统计学意义（P〉0.05）。治疗后第7天,维生素E组及叶酸联合维生素E组患者NIHSS评分较对照组明显降低（P〈0.05）;治疗后1个月,叶酸联合维生素E组患者NIHSS评分较对照组明显降低（P〈0.05）。结论 叶酸联合维生素E可以改善缺血性脑卒中合并高同型半胱氨酸血症患者的早期预后,其机制可能与抗氧化剂维生素E抑制Hcy的氧化损伤有关。

英文摘要：

Objective To study the effect of folic acid plus vitamin E on prognosis of ischemic stroke patients with hy- perhomocysteinemia（hHcy）. Methods From July 2015 to October 2016, 120 ischemie stroke patients with hHcy in De- partment of Neurology, the fifth people hospital of Datong were selected, and randomly divided into control group, folic acid alone group, vitamin E alone group and folic acid plus vitamin E group according to the block randomization, with thirty cases in every group. The level of Hey was detected before treatment, 1 month and 3 months after treatment, and NIHSS scores were recorded before treatment, 7 days and 1 month after treatment, the difference of Hey level and NIHSS scores among all groups were analysed. Results 1 month and 3 months after treatment, plasma Hcy level was unchanged in the control group and vitamin E alone group （P 〉 0.05）, while the plasma Hcy level in the folie acid alone group and folic acid plus vitamin E group were decreased significantly（P 〈 0.05）. 7 days and 1 month after treat- ment, there were no differences in the NIHSS scores between folie acid alone group and control group （P 〉 0.05）. 7 days after treatment, compared with control group, the NIHSS scores of the vitamin E alone group and folic acid plus vitamin E group were decreased （P 〈 0.05）. 1 month after treatment, compared with control group, the NIHSS scores of the folic acid plus vitamin E group were decreased （P 〈 0.05）. Conclusion Folic acid combine with vitamin E can im- prove the early prognosis of ischemic stroke patients with hHcy, and the mechanism may be associated with the antiox- idant vitamin E inhibiting oxidative stress of Hcy.