Study on the characteristics of pathological changes in patients with unstable walking and folic acid deficiency
- VernacularTitle:行走不稳伴叶酸缺乏患者病变特征研究
- Author:
Aiyong YU
1
;
Yingchun ZHAO
1
;
Sheng CHEN
1
Author Information
- Publication Type:Journal Article
- Keywords: Folic acid; Cerebral ischemia; Walking stability
- From: Journal of Apoplexy and Nervous Diseases 2020;37(11):1021-1026
- CountryChina
- Language:Chinese
- Abstract: Objective A group of patients with instability of walking as the main manifestation and combined with hypofolateemia were collected and their clinical characteristics were summarized. Methods 54 patients with folic acid <3.1 IU/ml，without cerebrovascular disease，whose first symptom manifested as "walking instability" were classified as the first group with folic acid deficiency in walking instability. Folic acid <3.1 IU/ml combined with cerebrovascular disease was listed as the control group of folic acid reduction combined with cerebrovascular disease，a total of 129 patients. The characteristics of baseline data，biochemical metabolism data，and brain MRI brain ischemic lesion distribution were compared between the two groups，and Logistic multivariate regression analysis was performed. Results The onset of folic acid deficiency in the onset of walking instability was （7.56±8.78） days，which was longer than the folic acid deficiency combined cerebrovascular disease control group at （5.19±6.87） days，t=4.586，P=0.001.The onset age of folic acid deficiency in the first manifestation of walking instability was （77.11±9.97） years，which was higher than the folic acid deficiency combined cerebrovascular disease control group at （73.30±12.42） years，t=2.906，P=0.022.The homocysteine in the folic acid deficiency group at the first manifestation of unstable walking was （19.88±9.00），which was lower than the folic acid deficiency combined with cerebrovascular disease control group （30.38±59.77），t=2.938，P=0.021.Focal deficiencies in the folic acid-deficient group at the onset of walking instability were higher （41.67%） than in the control group （33.72%），χ2=6.254，P=0.012.Instability of walking was first manifested in the folic acid-deficient group，and most of the ischemic foci in the cerebral hemisphere were spot-shaped and independent. Folate deficiency combined with cerebrovascular disease control group，most of the cerebral hemisphere ischemic lesions were fused into linear，band-shaped lesions with blurred borders. Using the folic acid deficiency group as the dependent variable for the first manifestation of walking instability，a binary logistic multivariate regression analysis revealed that the cerebral lobe ischemic focus was OR=2.311，95%CI 1.174～4.569，P=0.025.Conclusion Patients with instability in walking and folic acid deficiency may have a longer onset，older age，and insignificant increase in homocysteine levels. A cranial MRI examination showed frontal，temporal and parietal lobes. The number of cerebral lobe ischemic foci is relatively large，and they are distributed in a dot-like and independent manner.
- Full text:2024073115372099719行走不稳伴叶酸缺乏患者病变特征研究.pdf
