叶酸联合甲钴胺治疗对COPD稳定期伴高Hcy血症患者氧化应激、炎症因子及肺功能的影响

目的探索叶酸联合甲钴胺治疗对慢性阻塞性肺疾病(COPD)稳定期伴高同型半胱氨酸(Hcy)血症患者氧化应激、炎症因子及肺功能的影响。 方法选取2016年7月至2018年6月在陆军军医大学第一附属医院呼吸内科诊治的COPD稳定期伴高Hcy血症患者89例为研究对象，随机分为对照组和治疗组，对照组患者采用常规治疗，观察组患者在常规治疗基础上加服叶酸片联合甲钴胺分散片，治疗8周，比较治疗前、后两组患者外周静脉血Hcy、氧化应激指标超氧化物歧化酶(SOD)、丙二醛(MDA)]、炎症因子C反应蛋白(CRP)、白细胞介素6(IL-6)]水平及肺功能指标第一秒用力呼气容积占预计值的百分比(FEV₁%pred)、第一秒用力呼气容积/用力肺活量(FEV₁/FVC)]的变化。 结果叶酸联合甲钴胺治疗组与对照组患者的一般情况及治疗前外周血Hcy、SOD、MDA、CRP、IL-6水平及肺功能指标(FEV₁%pred、FEV₁/FVC)无统计学差异(P>0.05)；与治疗前相比，对照组患者治疗后血Hcy、氧化应激及炎症水平、肺功能指标无明显变化(P>0.05)，治疗组患者治疗后上述指标均有所改善(P<0.05)；与对照组比较，治疗组患者治疗后外周血Hcy、MDA、CRP、IL-6水平显著降低(P<0.05)，SOD、FEV₁%pred及FEV₁/FVC显著升高(P<0.05)。 结论叶酸联合甲钴胺治疗可有效降低COPD稳定期伴高Hcy血症患者外周血Hcy水平，降低其氧化应激及炎症因子水平，并显著改善患者肺功能。

Effects of folic acid combined with mecobalamin on oxidative stress,inflammatory factors and lung functions in patients with stable chronic obstructive pulmonary disease complicated with hyperhomocysteinemia

Objective To explore the effects of folic acid combined with mecobalamin on the oxidative stress,inflammatory factors and pulmonary functions in the patients with stable chronic obstructive pulmonary disease(COPD)complicated with hyperhomocysteinemia.Methods A total of 89 patients with stable COPD complicated with hyperhomocysteinemia diagnosed in our hospital from July 2016 to June 2018 were selected,and they were randomly divided into a control and an observation group.The control group was treated with conventional treatments,and the observation group was given folic acid combined with mecobalamin on the basis of the conventional treatments.All the patients were treated for 8 weeks.The levels of homocysteine(Hcy),oxidative stress markerssuperoxide dismutase(SOD)and malondialdehyde(MDA)],inflammatory factorsC-reactive protein(CRP)and interleukin 6(IL-6)]and pulmonary function indexesthe forced expiratory volume in one second as percentage of predicted volume(FEV 1% pred),the forced expiratory volume in one second/the forced vital capacity(FEV 1/FVC)]of the patients in the two groups before and after treatment were compared.Results The general situation and levels of Hcy,SOD,MDA,CRP,IL-6,FEV 1% pred and FEV 1/FVC before treatment showed no significant difference between the two groups(P>0.05).There was no significant difference in the levels of Hcy,SOD,MDA,CRP,IL-6,FEV 1% pred and FEV 1/FVC before and after treatment in the control group(P>0.05),while they were ameliorated in the observation group(P<0.05).The levels of Hcy,MDA,CRP and IL-6 were reduced(P<0.05)and the levels of SOD,FEV 1% pred and FEV 1/FVC were increased(P<0.05)after treatment in the observation group compared with the control group.Conclusion Folic acid combined with mecobalamin can effectively reduce the levels of Hcy and improve the status of oxidative stress,inflammation and pulmonary functions in the patients with COPD complicated with hyperhomocysteinemia.