小剂量叶酸配合治疗对“H”型高血压患者血同型半胱氨酸水平及颈动脉内膜中层厚度的影响

Effect of low dose of folic acid on the level of blood homocysteine and carotid intima media thickness in patients with “H” type hypertension

目的探讨小剂量叶酸配合降压药物治疗对"H"型高血压患者血同型半胱氨酸(Hcy)水平及颈动脉内膜中层厚度(CIMT)的影响。方法选取2016年1~5月我院收治的老年"H"型高血压患者150例,随机分为对照组与观察组,每组75例。对照组患者给予常规药物降压治疗,观察组患者在对照组治疗的基础上口服小剂量叶酸治疗,0.8 mg/d。比较两组患者治疗前、治疗后第3、6、12个月的血Hcy水平及CIMT厚度。结果两组患者治疗前血Hcy水平比较,差异无统计学意义(P>0.05);治疗后第3、6、12个月,观察组患者血Hcy水平均低于对照组,差异均有统计学意义(P<0.01)。治疗前、治疗后第3个月,两组患者CIMT比较差异无统计学意义(P>0.05);治疗后第6、12个月,观察组患者CIMT均显著低于对照组,差异有统计学意义(P<0.05)。结论常规降压药物配合口服小剂量叶酸治疗可有效地降低"H"型高血压患者血Hcy水平,减缓颈动脉内膜的进展,值得在临床推广应用。

Objective To investigate the effect of low dose folic acid combined with antihypertensive drugs on blood homocysteine（ Hcy） level and carotid intima media thickness（ CIMT） in patients with＂H＂type hypertension. Methods 150 cases of elderly ＂H＂hypertension patients were selected from January to May 2016 in our hospital,and randomly divided into the control group and the observation group,75 cases in each group. The control group were treated with routine antihypertensive,and the observation group were treated with low dose of folic acid on the basis of the control group,0. 8 mg/d. The blood Hcy level and the thickness of CIMT were compared between the two groups before treatment and third,sixth,twelfth months after treatment.Results There was no significant difference in the blood Hcy level between the two groups before treatment（ P〈0. 05）. After third,sixth,twelfth months of treatment,the blood Hcy level of the patients in the observation group was lower than that of the control group,the difference was statistically significant（ P〈0. 01）. Before treatment and third months after treatment,there was no significant difference in CIMT between the two groups（ P〈0. 05）. After sixth,twelfth months of treatment,the CIMT in the observation group was significantly lower than that in the control group,and the difference was statistically significant（ P〈0. 05）.Conclusion Routine antihypertensive drugs combined with oral low dose folic acid treatment can effectively reduce the blood Hcy level of H type hypertension patients and slow down the progress of carotid intima,which is worthy of clinical application.