Abstract: Objective   To investigate whether Vitamin B complex supplements would reduce stroke-related disability in hyperhomocysteinemia patients with recent ischemic stroke. Methods   1000 brain infarction patients with hyperhomocysteinemia were assigned to receive either a daily dose of Vitamin B complex (Treatment group, n=500) or not (Control group, n=500) on the base of conventional secondary prevention medications for a period of 2 years. Neurological dysfunction was assessed by National Institutes of Health Stroke Scale (NIHSS) and stroke disability was evaluated by Barthel Index (BI) score. High performance liquid chromatographic method with fluorescence detection was used for the determination of total plasma homocysteine levels. After 2 years of follow-up, the patients in the treatment group, whose tHcy level was reduced by 3-μmol/L or more, was defined as the treatment subgroup. Results  Homocysteine levels were significantly reduced in the treatment group. A lower NIHSS Scale was obtained at 12m, 18m, 24m in the treatment group compared to that in the control group (P<0.05), there were no statistical significance difference in the two groups at other time points (P>0.05). For the BI score, there were no statistical significance difference in the two groups at any time points (P>0.05). After 2 years of Vitamin B complex supplementation, the treatment subgroup was associated with a lower NIHSS Scale and higher BI Scale compared to that in the control group (P<0.05). Conclusion   Lowering of homocysteine may have bneficial effects on neurological functional outcome at 1-2 year after stroke onset. Who have significant reduction of homocysteine level, may be most likely to benefit from treatment with B vitamins.

Key words: vitamin B complex, hyperhomocysteinemia, brain infarction, prognosis, total homocysteine, neurological deficit, national institutes of health stroke scale score, NIHSS 评分