Analysis of the effect of folic acid combined with mecobalamin in the treatment of cerebral small vessel disease with hyperhomocysteinemia

Abstract

Objective To investigate the clinical effect of folic acid combined with methylcobalamin in the treatment of cerebral small vessel disease with hyperhomocysteinemia. Methods From January 2015 to December 2016, 78 patients who were diagnosed cerebral small vessel disease with high homocysteinemia(Hcy) and also associated with vascular mild cognitive impairment in the Second People's Hospital of Liaocheng were selected as the research objects, and they were randomly divided into control group and observation group, with 39 cases in each group.The control group was given routine treatment, and the observation group was treated with folic acid combined with mecobalamin on the bassis treatment of the control group.The levels of The Hcy, vitamin B12, folic acid and the Alzheimer's disease assessment scale-cognitive subscale(ADAS-cog) scores before and after treatment for 3 and 6 months were compared between the two groups. Results Before treatment, there was no statistically significant difference in the level of plasma Hcy between the two groups(t=0.34, P=0.74). There was no statistically significant difference in the level of plasma Hcy of the control group between before and after 3 and 6 months treatment(t=0.36, 1.30, all P>0.05). The plasma Hcy level in the observation group after 3 and 6 months treatment[(19.98±3.65)mol/L, (14.96±3.54)mol/L] were significantly lower than that before treatment[(26.38±2.95)mol/L](t=8.52, 15.48, all P 0.05). There was no statistically significant difference in the levels of vitamin B12 and folic acid of the control group between before and after 3 and 6 months treatment(all P>0.05). The vitamin B12 and folic acid levels in the observation group after 3 and 6 month treatment were significantly higher than those before treatment(all P 0.05). There was no statistically significant difference in the ADAS-cog scale score of the control group between before and after 3 and 6 months treatment(all P>0.05). The scores of ADAS-cog scale in the observation group after 3 and 6 months treatment[(12.05±2.13)points, (10.24±2.84)points] were significantly lower than that before treatment[(15.07±3.56)points](t=4.55, 6.62, all P<0.05), which were also significantly lower than that in the control group(all P<0.05). Conclusion Folic acid combined with methylcobalamin in the treatment of cerebral small vessel disease with hyperhomocysteinemia can significantly reduce the Hcy, vitamin B12 and folic acid levels, which can help to relieve the vascular cognitive impairment, so it is worthy of promotion and application. Key words: Basal ganglia cerebrovascular disease; Hyperhomocysteinemia; Folic acid; Mecobalamin