叶酸、甲钴胺对“H型”原发性高血压肾病患者尿蛋白的影响

Impact of folic acid and Calomide-Me on urinary protein in patients with H type hypertensive nephropathy

目的探讨叶酸、甲钴胺对H型原发性高血压肾病患者尿蛋白的影响。方法原发性高血压患者94例,将患者随机分为:叶酸治疗组(n=30)、甲钴胺治疗组(n=31)、叶酸+甲钴胺治疗组(n=33)。入选病例均在常规降压基础上,给予相应药物治疗3个月,治疗前后分别测定血压、血浆同型半胱氨酸、血肌酐、尿素氮、24h尿蛋白定量。结果 (1)经治疗后,叶酸治疗组、甲钴胺治疗组及联合治疗组与治疗前相比Hcy均有不同程度下降(P<0.01),联合治疗组较单独应用叶酸、甲钴胺治疗组血浆Hcy下降明显(P<0.05)。(2)经叶酸和(或)甲钴胺治疗前后及治疗后各组间SCr、BUN差异无统计学意义(P>0.05);治疗后各组24hU-Pro较治疗前显著降低(P<0.05),尤其是联合治疗组较单独应用叶酸、甲钴胺治疗组24hU-Pro下降更为显著(P<0.01)。结论应用叶酸、甲钴胺,尤其是二者联用,可有效降低H型原发性高血压肾病患者血浆Hcy水平,并在一定程度上减少尿蛋白的排泄,保护肾脏功能。

Objective To investigate the impact of folic acid and Calomide-Me on urinary protein in patients with H type hypertensive nephropathy. Methods 94 patients with hypertensive nephropathy in our hospital were selected and divided into folic acid group （n=30）,Calomide-Me group（n=3 l）and folic acid puls Calomide-Me group（n=3）,according to the different kinds of drugs given to them.All of the patients were treated for 3 months on the base of routine decompression treatment,and more,HCY,BUN,SCr and 24bU-Pro of these patients were assay and compared before and after treatment. Results （l）After 3 months of treatment, HCY of the patients in the three groups were all reduced significantly（P 〈 0.01 ）,especially in the folic acid puls Calomide-Me group（P 〈 0.05）. （2）After treatment, there were no significant improvement on BUN,SCr of the patients in tile three groups （P 〉 0.05）,however,24hU-Pro of the patients in the three groups were all reduced significantly（P 〈 0.05 ）,especially in the folic acid puls Calomide-Me group（P 〈 0.01）. Conclusion Using folio acid and Calomide-Me in patients with H type hypertensive nephropathy may reduce Hey level of patients, meanwhile,may reduce urinary protein excretion in different degree and protect kidney.