叶酸联合降压药治疗高同型半胱氨酸血症合并高血压的临床效果分析

Clinical Effect of Folic Acid Combined with Antihypertensive Drugs in Treatment of Hyperhomocysteinemia and Hypertension

目的:分析叶酸联合降压药治疗高同型半胱氨酸(Hcy)血症合并高血压的临床效果。方法:选取2020年8月—2022年8月上海市杨浦区五角场社区卫生服务中心收治的92例高Hcy血症合并高血压患者作为研究对象,采用随机数字表法分为对照组与联合组,各46例。对照组给予降压药治疗,联合组在对照组基础上给予叶酸治疗。比较两组血压水平、Hcy水平、颈总动脉后壁内-中膜厚度、血流阻力指数、斑块面积、不良事件发生情况。结果:治疗前,两组收缩压(SBP)、舒张压(DBP)、血浆Hcy水平比较,差异无统计学意义(P>0.05);治疗后,两组SBP、DBP、血浆Hcy水平低于治疗前,且联合组低于对照组,差异有统计学意义(P<0.001)。治疗前,两组颈总动脉后壁内-中膜厚度、血流阻力指数、斑块面积比较,差异无统计学意义(P>0.05);治疗后,两组颈总动脉后壁内-中膜厚度、血流阻力指数低于治疗前,且联合组低于对照组,两组斑块面积小于治疗前,且联合组小于对照组,差异有统计学意义(P<0.05)。结论:叶酸联合降压药治疗高Hcy血症合并高血压的临床效果显著,可降低患者血压、血浆Hcy水平,减缓颈动脉粥样硬化进展,且安全性较高。

Objective:To analyze the clinical effect of folic acid combined with antihypertensive drugs in treatment of hyperhomocysteinemia and hypertension.Methods:A total of 92 patients with hyperhomocysteinemia and hypertension who were admitted to Shanghai Yangpu District Wujiaochang Community Health Service Center from August 2020 to August 2022 were selected as the study subjects.They were divided into control group and combination group according to random number table method,with 46 cases in each group.The control group was treated with antihypertensive drugs,and the combination group was treated with folic acid on the basis of the control group.Blood pressure level,homocysteine(Hcy)level,intima-media thickness of common carotid artery posterior wall,blood flow resistance index,plaque area,and occurrence of adverse events were compared between the two groups.Results:Before treatment,there was no significant difference in systolic blood pressure(SBP),diastolic blood pressure(DBP)and plasma Hcy levels between the two groups(P>0.05).After treatment,the SBP,DBP and plasma Hcy levels in the two groups were lower than those before treatment,and the levels in the combination group were lower than those in the control group,and the difference was statistically significant(P<0.001).Before treatment,there was no significant difference in the intima-media thickness of common carotid artery posterior wall,blood flow resistance index and plaque area between the two groups(P>0.05).After treatment,the intima-media thickness of common carotid artery posterior wall and blood flow resistance index in the two groups were lower than those before treatment,and these indexes in the combination group were lower than those in the control group,while the plaque area in the two groups was smaller than that before treatment,and the plaque area in the combination group was smaller than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:The combination of folic acid and antihypertensive drugs has significant clinical effects in treatment of hyperhomocysteinemia and hypertension,and can reduce the blood pressure level and plasma Hcy level,slow down the progression of carotid atherosclerosis,and have high safety.