叶酸对不同MTHFR 基因型合并H型高血压脑梗死的疗效
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摘要
目的探讨叶酸对不同MTHFR基因型合并H型高血压的脑梗死疗效情况。方法筛查出合并H型高血压的脑梗死患者共352例,随机分为治疗组和对照组,两组均予测定MTHFR基因型,对照组予降压等常规必要的治疗,治疗组在对照组的基础上予叶酸治疗,随访观察患者血浆Hcy水平、血压水平、NIHSS评分的变化。结果经治疗12周后,治疗组血浆Hcy水平较前明显下降,与对照组比较差异有统计学意义(P<0.05),治疗组TT基因型组下降幅度较大;治疗组与对照组的血压水平、NIHSS评分的变化差异无统计学意义(P>0.05)。结论叶酸对于不同MTHFR基因型合并H型高血压的脑梗死患者有明显降Hcy的效果,尤其是TT基因型的效果更佳显著。
引文
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[11] 张宇,王林.同型半胱氨酸与H 型高血压研究进展[J].中华老年病研究电子杂志,2016,3(1):30-38.
[2] ZHONG C,LV L,LIU C,et al.High homocysteine and blood pressure related to poor outcome of acute ischemia stroke in Chinese population[J].PLoS One,2014,29(9):107498.
[3] SPENCE J D.Metabolic vitamin B12 deficiency:a missed opportunity toprevent dementia and stroke[J].Nutr Res,2016,36(2):109-116.
[4] XANTHAKIS V,ENSERRO D M,Murabito J M,et al.Ideal cardiovascularhealth:associations with biomarkers and subclinical disease and impact on incidence of cardiovascular disease in the Framingham Offspring Study[J].Circulation,2014,130(19):1676-1683.
[5] DONG C,RUNDEK T,WRIGHT C B,et al.Ideal cardiovascular health predicts lower risks of myocardial infarction,stroke,nd vascular death across whites,blacks,and Hispanics:the Northern Manhattan Study[J].Circulation,2012,125(24):2975-2984.
[6] 《中国高血压防治指南》修订委员会.中国高血压防治指南2018年修订版[J].心脑血管病防治,2019,19(1):1-44.
[7] 李才明,张成,卢锡林,等.N5,N10-亚甲基四氢叶酸还原酶基因与缺血性脑卒中发病的关系[J].中国危重病急救医学,2006,18(5):264-267.
[8] SAYUTI S,DAMITRI T.B vitamins in patients with recent transient ischaemic attack or stroke in the VITAmins To Prevent Stroke(VITATOPS)trail:a randomised,double-blind,parallel,placebo-controlled trail[J].The Lancet Neurology,2010,9(9):855-865.
[9] HANKEY G J,EIKEBLOOM J W,YI Q,et al.Antiplatelet therapy and the effects of B vitamins in patients with previous stroke or transient ischaemicattack;a posthoc subanalysis of VITATOPS,a randomised,double-blind,parallel,placebo-controlled trail[J].Lancet Neurol,2012,11(6):512-520.
[10] 刘涓涓,李才明,罗秋云,等.叶酸对合并H型高血压的脑梗死患者的二级预防作用[J].泰山医学院学报,2015,36(3):244-246.
[11] 张宇,王林.同型半胱氨酸与H 型高血压研究进展[J].中华老年病研究电子杂志,2016,3(1):30-38.