叶酸联合缬沙坦治疗H型高血压的临床研究

Clinical study of folic acid combined with valsartan in treatment of patients with H type hypertension

目的观察叶酸联合缬沙坦治疗H型高血压的疗效及其对血管内皮功能(FMD)、动脉内膜中层厚度(IMT)和一氧化氮(NO)水平的影响。方法选择2012年1月—2014年12月就诊的H型高血压的患者60例,随机分为观察组和对照组,每组各30例。对照组予以缬沙坦治疗,观察组在对照组的基础上予以叶酸治疗。观察两组的疗效,治疗前后收缩压、舒张压、Hcy、FMD、IMT和NO水平的变化。结果观察组的总有效率为96.67%,明显高于对照组的73.33%(P<0.05)。治疗后两组的收缩压,舒张压和IMT均较治疗前明显降低(P<0.01),而观察组的降低水平更为明显(P<0.01),两组的FMD和NO水平较治疗前出现明显升高(P<0.01),而FMD和NO升高水平更为明显(P<0.01),观察组的Hcy水平较治疗前和对照组出现明显降低(P<0.01)。结论叶酸联合缬沙坦H型高血压的疗效显著,可能与降低机体的Hcy水平,降低动脉内膜厚度,改善内皮功能具有一定的联系。

Objective To evaluate the curative efficacy of folic acid combined with valsartan in patients with H typehypertension and their impact on the flow mediate dilation（FMD）, intima media thickness（IMT）and nitric oxide（NO）.Methods A total of 60 patients with type H hypertension, from January 2012 to December 2014, were randomly divided intoobservation group and control group, at 30 cases each group. The control group was given valsartan treatment, the observationgroup was given valsartan combined with folic acid. The efficacy post treatment and the levels of systolic pressure, diastolicpressure, Hcy, FMD, IMT and NO before and after the treatments were studied. Results The effective rate was 96.67% inobservation group, significantly higher than 73.33% in control group（P〈0.05）. After the treatment, the levels of systolicpressure, diastolic pressure and IMT in two groups were significantly lower than those before treatment（P〈0.0）. Thedecreased levels in observation group were more obvious（P〈0.0）and the levels of FMD and NO in two groups were increasedsignificantly, compared with those before treatment（P〈0.0）. The increased levels of FMD and NO in observation group weremore obvious（P〈0.0）. The levels of Hcy was significantly decreased, compare with those before treatment and in controlgroup（P〈0.0）. Conclusion Efficacy of folic acid combined with valsartan in patients with H type hypertension is obvious.It may be related to decreased Hcy levels and reduced arterial intimal thickness, and improved endothelial function.