Abstract
To analyze the effect of mecobalamin on the early-functional outcomes of patients with ischemic stroke and H-type hypertension. From October of 2014 to October of 2016, 224 cases of ischemic stroke and H-type hypertension were selected. The patients were randomly divided into treatment control groups, with 112 patients in each group. The control group was treated with the conventional therapy. The observation group was treated with 500 µg of mecobalamin three times a day in addition to the conventional therapy. We compared serum homocysteine (Hcy), hs-CRP levels, carotid plaques, and NIHSS scores between the two groups on the 2nd day and at 4 weeks, 8 weeks, 3 months, and 6 months. After 4 weeks, 8 weeks, 3 months and 6 months, the difference of serum Hcy level between the two groups was statistically significant (t = 4.049, 3.896, 6.052, 6.159, respectively. All P <0.05). After the treatment, at 4 weeks, 8 weeks, 3 months and 6 months, the levels of hs-CRP in the treatment group were significantly lower than those in the control group (t = 37.249, 28.376, 26.454, 20.522, respectively. All P <0.01). After 3 months and 6 months, the carotid artery plaques were significantly reduced in the treatment group compared to those in the control group (t = 2.309 and 2.434. All P <0.05). After 3 months and 6 months, the NIHSS score was significantly higher in the treatment group compared to those in the control group (t = 2.455 and 2.193. All P <0.05). Mecobalamin can reduce the level of plasma homocysteine, then lead to reductions of levels of plasma inflammatory factors and volume of carotid artery plaques, resulting in more significant functional recovery.
Highlights
H-type hypertension is defined as hypertension with plasma homocysteine (Hcy) levels over 10 μmol / L 1-3
After 3 months and 6 months, the carotid artery plaques were significantly reduced in the treatment group compared to those in the control group
After 3 months and 6 months, the National Institute of Health stroke scale (NIHSS) score was significantly higher in the treatment group compared to those in the control group
Summary
H-type hypertension is defined as hypertension with plasma homocysteine (Hcy) levels over 10 μmol / L 1-3. Previous studies have shown that only 5% of the average population has an increase in plasma Hcy levels. In the stroke patient population, approximately 30-40% has Hcy level increases[4]. H-type hypertension is closely related to ischemic stroke and cerebral infarction 5. As a common neurological disease, ischemic stroke has high incidence, recurrence, mortality rates and has become a serious threat to patient’s health and life in recent years. Previous studies have shown that the underlying relationship mechanism between a high plasma Hcy level and ischemic stroke is that Hcy causes inflammation and increases carotid artery plaques 6, 7
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