MTHFR基因型对叶酸治疗老年脑卒中后认知功能障碍的影响

摘要

目的 探讨不同亚甲基四氢叶酸还原酶(MTHFR)基因型对老年脑卒中病人认知功能障碍的影响效果.方法 选取我院收治的159例脑卒中病人,随机分干预组(78例)和对照组(81例).2组病人同时接受脑卒中常规治疗,干预组在常规治疗的基础上给予病人口服叶酸5 mg/d并测定其MTHFR基因型,分别于入院后的第1天和第8周行简易神经状态检查(MMSE)和日常生活活动能力(ADL)量表评分.结果 干预组中MTHFR基因为TT型的病人基线MMSE、ADL评分显著低于对照组及干预组CT型和CC型病人(P<0.05);干预组第8周MMSE、ADL评分都显著高于对照组(P<0.05),其中干预组MTHFR基因TT型病人的评分提高相对更加显著.结论 叶酸支持有助于脑卒中病人的认知功能恢复,其中MTHFR基因TT型病人对干预更加敏感.%Objective To investigate the association of MTHFR genotypes with the efficacy of folic acid supplementation on the cognitive function in the elderly patients with stroke. Methods A total of 159 patients with stroke were randomly divided into intervention group ( n=78 ) ( receiving 5 mg/d folic acid supplementation ) and control group ( n=81 ) . The MTHFR genotypes of patients in intervention group were detected. Both groups received questionnaire survey ( MMSE & ADL) 1 d and 8 weeks after intervention. Results Compared to the control group, the cognitive function in intervention group was significantly improved(P<0. 05),especially in those patients with genotype TT. Conclusions This study shows that folic acid supplementation can be helpful in improving the cognitive function of patients with stroke, and genotype TT may be associated with the effects.