不同剂量叶酸对不同MTHFR基因型缺血性脑卒中伴高同型半胱氨酸血症患者同型半胱氨酸水平的影响

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Abstract Objective To investigate the therapeutic effect of different doses of folic acid on the treatment of hyperhomocysteinemia in patients with different methylene tetrahydrofolate reductase genotypes of ischemic stroke, and to find an appropriate folic acid treatment scheme. Methods A total of 376 ischemic stroke patients with hyperhomocysteinemia who were admitted to the Department of Neurology and Rehabilitation Medicine of the First Affiliated Hospital of Xinjiang Medical University from January 2017 to December 2019 were selected. Methylene tetrahydrofolate reductase C677T site gene was detected, and they were divided into TT type, CT type and CC type. According to random number table, they were divided into high-dose folic acid group (188 cases, 5.0 mg/d) and low-dose folic acid group (188 cases, 0.8 mg/d). Blood homocysteine level was measured before treatment, four weeks after treatment, and three months after treatment. Results For CT and TT genotypes, the homocysteine level of the high-dose folic acid group was lower than that of the low-dose folic acid group after four weeks of treatment, the difference was statistically significant (P ＜ 0.05). After three months of treatment, there was no significant difference in homocysteine levels between the two groups (P ＞ 0.05). For CC genotype, there was no significant difference in homocysteine levels between the two groups before treatment, after four weeks and three months of treatment (P ＞ 0.05). For the three genotypes, after four weeks and three months of treatment, the homocysteine level in the two groups was lower than that before treatment, after three months of treatment, the homocysteine level in the two groups was lower than that after four weeks of treatment, the differences were statistically significant (P ＜ 0.017). Conclusion For patients with ischemic stroke with hyperhomocysteinemia, personalized folic acid therapy should be developed according to different methylene tetrahydrofolate reductase C677T genotypes.

Key words： methylene tetrahydrofolate reductase gene C677T Folic acid Homocysteine Ischemic stroke

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	LU Xiaoyan REN Yu

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LU Xiaoyan REN Yu. Effects of different doses of folic acid on homocysteine levels in patients with different MTHFR genotypes of ischemic stroke with hyperhomocysteinemia[J]. 中国医药导报, 2021, 18(17): 90-93.

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https://www.yiyaodaobao.com.cn/EN/ OR https://www.yiyaodaobao.com.cn/EN/Y2021/V18/I17/90

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