叶酸干预H型高血压患者血浆同型半胱氨酸及动脉硬化的疗效

The effect of folic acid on plasma homocysteine and atherosclerosis in patients with type H hypertension

目的探讨叶酸干预治疗对H型高血压患者血浆同型半胱氨酸(Hcy)代谢变化及脉搏波传导速度(PWV)的影响。方法收集2014年3-12月就诊的H型高血压患者,用随机数字表法随机分为治疗组和对照组,均给予常规长效降压药物治疗,治疗组同时给予口服叶酸0.8 mg/d,对照组给予安慰剂治疗,每日1次,两组疗程均为12个月,观察血浆Hcy及PWV水平变化。结果共入选432例H型高血压患者,全为汉族,年龄(61.7±13.6)岁,男∶女=1.3∶1,合并疾病最多的为冠心病和2型糖尿病。两组给予治疗时间12个月,随访时间6~10个月,平均8个月,治疗后两组血浆Hcy(Z=-7.63,P=0.000)及PWV(Z=-3.16,P=0.002)水平差异有统计学意义。结论叶酸干预治疗可以明显使H型高血压患者的血浆Hcy水平降低,减缓动脉粥样硬化进程,降低心血管病危险因素。

Objective To investigate the effect of folic acid intervention on plasma homocysteine（Hcy）metabolic changes and pulse wave velocity（PWV）in patients with type H hypertension. Methods Patients（hos-pitalized from March 2014 to December in our hospital）with H type hypertension were randomly divided into treat-ment group and control group randomly,and were given routine antihypertensive drug therapy. Treatment groupwas given oral folic acid 0.8 mg,1 times a day,the control group was given placebo,1 times a day. All patientwere treated for 12 months. Changes of plasma Hcy and PWV levels were observed. Results 432 patients（Hannationality）with type H hypertension were enrolled in this study with the age of 61.7 ± 13.6 years old and the ratioof men and women is 1.3∶1. The most common diseases were coronary heart disease and type 2 diabetes mellitus.2 groups were treated for a period of 12 months,with follow-up time from 6 to 10 months（average duration in 8 months）. After treatment,the difference between plasma Hcy（Z =-7.63,P = 0.000）and PWV（Z =-3.16,P =0.002）levels of the two groups were statistically significant. Conclusion Folic acid intervention can significantlyreduce the level of plasma Hcy in patients with type H hypertension,slow down the progression of atherosclerosisand reduce the risk factors of cardiovascular disease.