原发性高血压患者血浆同型半胱氨酸水平分析及叶酸的干预作用

The effect of folic acid therapy on blood pressure in hypertensive patients with high plasma homocysteine

目的探讨原发性高血压合并血浆同型半胱氨酸(Hcy)增高者叶酸对血压的影响。方法收集我院门诊原发性高血压患者600例。采用循环酶法测定血浆Hcy水平,根据Hcy水平将观察组分为高Hcy者及Hcy正常者,均给予叶酸治疗,4周、24周后再次检测Hcy及动态血压。结果高Hcy者456例,Hcy正常者144例。高Hcy者患者经叶酸治疗4周、24周,Hcy水平、24 h平均动脉收缩压、24 h平均动脉舒张压、夜间平均收缩压、夜间平均舒张压均较治疗前明显下降,差异有统计学意义(P<0.05或0.01),Hcy正常者经叶酸治疗后血压无明显动态改变。结论高血压合并高Hcy血症患者,叶酸治疗有助于降低血压。

Objective To investigate the effect of folic acid therapy on blood pressure in hypertensive patients with high plasma homocysteine level. Methods 600 hypertensive outpatients were enrol ed and divided into high homocysteine group and normal homocysteine group based on plasma homocysteine level measured by enzymatic cycling method. Al patients were treated with folic acid. Plasma homocysteine concentration and ambulatory blood pressure were measured at 4 and 24 weeks later. Results 456 hypertensive patients had high homocysteine level and 144 had normal homocysteine level. After folic acid treatment, the plasma homocysteine level, 24 h mean arterial systolic pressure, 24 h mean arterial diastolic pressure, mean nighttime systolic pressure and mean nighttime diastolic pressure at 4 and 24 weeks, were significantly decreased in high homocysteine group （al P〈0.01） but not in normal homocysteine group. Conclusion Folic acid treatment may be beneficial to reduce blood pressure in hypertensive patients with high homocysteine level.