叶酸对老年高血压患者血浆同型半胱氨酸水平和认知功能的影响

Effect of folate supplementation on plasma homocysteine level and cognitive function in elderly patients with essential hypertension

目的观察叶酸对老年高血压患者血浆同型半胱氨酸(Hcy)水平和认知功能的影响。方法老年高血压患者104例,按照随机数字法分为试验组和对照组,每组52例。对照组以常规型降压药物进行治疗,试验组在对照组基础上口服叶酸。两组疗程均为8周。分别于治疗前后对两组病患进行血浆Hcy水平测定,并在入院次日和第8周进行简易精神状态检查量表(MMSE)测评。结果疗程结束后,试验组的Hcy水平低于治疗前,也低于对照组治疗后;MMSE评分高于治疗前,也高于对照组治疗后,差异均有统计学意义(P<0.01)。治疗8周后,试验组和对照组在定向力、注意力和计算力方面评分均优于治疗前,且试验组优于对照组(P<0.01)。治疗前,3级高血压患者的血Hcy水平高于1、2级高血压患者,MMSE评分低于1、2级高血压患者(P<0.05或0.01),治疗后,3级高血压患者的血浆Hcy下降幅度明显大于1、2级高血压患者(P<0.05或0.01),2、3级高血压患者的MMSE量表评分提高幅度高于1级高血压患者(P<0.01)。结论在老年高血压病的治疗中,除控制血压外,及时补充叶酸可降低血浆Hcy水平,有利于认知功能的改善并延缓病情进展。

Objective To investigate the effect of folic acid supplementation on plasma homocysteine level and cognitive function in elderly hypertensive patients. Methods 104 cases of senile hypertension were randomly divided into Experimental Group and Control Group, 52 cases in each group. All the patients in Control Group were given conventional antihypertensive drugs for treatment while Experimental Group was treated with oral folic acid on the basis of the treatment for Control Group.The two groups were treated for 8 weeks. Plasma Hcy levels in both groups were measured before and after treatment. The Mini-Mental Status Examination（MMSE） was measures on the next day of admission and the 8 th week. Results After the treatment, the Hcy level of Experimental Group was lower than that before the treatment, and also lower than that of Control Group after the treatment; the MMSE score of Experimental Group was lower than that before the treatment, and also lower than that of Control Group after the treatment, and the difference was statistically significant（P〈0.01）. After a treatment of eight weeks, Experimental Group and Control Group had the orientation, attention and computational power superior to those before treatment, and Experimental Group was superior to Control Group（P〈0.01）. Before treatment, the patients with Grade3 hypertension had a higher blood Hcy level and a lower MMSE score than the patients with Grade 1 or 2 hypertension（P〈0.05 or 0.01）; after the treatment, the patients with Grade 3 hypertension had a blood Hcy level significantly decreased compared with the patients with Grade 1 or 2 hypertension（P〈0.05 or 0.01）, and the patients with Grade 2 or 3 hypertension had a MMSE score significantly increased compared with the patients with Grade 1 hypertension（P〈0.01）. Conclusion In the treatment of elderly patients with hypertension, in addition to the control of blood pressure, the timely supplementation of folic acid reduces blood Hcy in patients with cognitive impairment is conducive to the improvement of the impairment and delay the progression of the disease.