叶酸联合常规药物对H型高血压合并颈动脉粥样硬化患者Hcy代谢、炎症反应、斑块性质的影响

Effect of folic acid combined with routine drugs on Hcy metabolism,inflammatory response and plaque properties in patients with H-type hypertension complicated by carotid atherosclerosis

目的:探讨叶酸联合常规药物对H型高血压合并颈动脉粥样硬化患者Hcy代谢、炎症反应、斑块性质的影响。方法:收集在本院接受治疗的H型高血压合并颈动脉粥样硬化患者68例,随机分为对照组、观察组各34例。对照组接受常规治疗,观察组接受叶酸联合常规药物治疗。对比两组治疗前后Hcy代谢、炎症反应、斑块性质的差异。结果:治疗前,两组血清中Hcy含量、促炎及抗炎介质含量、超声斑块性质参数水平的差异无统计学意义(P>0.05)。治疗后,观察组血清中Hcy的含量低于对照组;血清中促炎因子IL-1、IL-6、IL-8、CRP的含量低于对照组;血清中抗炎因子IL-4、IL-10、IL-13的含量低于对照组;超声斑块性质参数斑块应变值低于对照组患者,斑块应变率高于对照组(P<0.05)。结论:H型高血压合并颈动脉粥样硬化在常规治疗的基础上加入叶酸治疗,可有效加速Hcy代谢、减轻全身炎症反应、增加斑块稳定性。

Objective：To explore the effect of folic acid combined with routine drugs on Hcy metabolism,inflammatory response and plaque properties in patients with H-type hypertension complicated by carotid atherosclerosis.Methods：A total of68 patients with H-type hypertension complicated by carotid atherosclerosis who received treatment in our hospital between January 2014 and September 2016 were collected and divided into control group（n=34）and observation group（n=34）according to random number table.The control group received routine therapy while the observation group received folic acid combined with routine drug therapy.The differences in Hcy metabolism,inflammatory response and plaque properties were compared between the two groups of patients before and after treatment.Results：Before treatment,differences in serum Hcy contents,pro-inflammatory and anti-inflammatory mediator contents,and ultrasound plaque property parameter levels were not statistically significant between two groups of patients（P 0.05）.After treatment,serum Hcy content of observation group was significantly lower than that of control group（P〉0.05）;serum pro-inflammatory factors IL-1,IL-6,IL-8and CRP contents were significantly lower than those of control group（P〈0.05）;serum anti-inflammatory factors IL-4,IL-10 and IL-13 contents were significantly lower than those of control group（P〈0.05）;ultrasound plaque property parameter strain value was significantly lower than that of control group while plaque strain rate was significantly higher than that of control group（P〈0.05）.Conclusions：Folic acid treatment based on routine treatment can effectively accelerate Hcy metabolism,reduce systemic inflammatory response and increase plaque stability in patients with H-type hypertension complicated by carotid atherosclerosis.