叶酸辅助治疗老年高血压病的效果及对Hcy、血管内皮功能影响
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摘要
目的研究叶酸辅助治疗老年高血压病的效果及对同型半胱氨酸Hcy、血管内皮功能影响。方法选择我院2015年3月1日~2018年3月1日收治的老年高血压病患者共62例,随机法原则分成对照组31例,实验组31例,对照组给予降压药物治疗,实验组在对照组的基础上联合叶酸治疗,治疗6个月后,观察两组老年高血压病患者治疗后的效果及对Hcy、血管内皮功能影响。结果对照组与实验组的治疗总有效率分别为64.52%和90.32%(P <0.05);两组患者血浆Hcy指标水平与治疗前相比均显著降低,实验组较对照组降低更为明显(P <0.05);两组患者一氧化氮(NO)、血管内皮依赖性舒张(FMD)指标水平较治疗前升高,内皮素-1(ET-1)、血栓素A2(TXA2)指标水平较治疗前降低,且实验组NO、FMD指标水平较对照组升高明显,ET-1、TXA2指标水平较对照组下降明显(P <0.05)。结论叶酸辅助治疗老年高血压病的效果较好,能够显著降低血浆Hcy水平,改善老年高血压病的血管内皮功能,减少功能损伤,具有一定的临床推广价值。
Objective To study curative effects of folic acid in the adjuvant treatment of senile hypertension and its effect on Hcy and vascular endothelial function. Methods 62 elderly patients with hypertension who were admitted and treated in our hospital from March 1,2015 to March 1,2018 were selected.According to the random principle,they were randomly divided into the control group(31 cases)and the experimental group(31 cases).The control group was treated with antihypertensive drugs while the experimental group was treated with folic acid on the basis of the control group.After 6 months of treatment,curative effects of elderly patients with hypertension and its effect on Hcy and vascular endothelial function in two groups were observed. Results The total effective rate of the control group and the experimental group were 64.52% and 90.32%,respectively(P < 0.05).The levels of plasma Hcy in both groups were significantly lower than those before treatment and the experimental group was significantly lower than the control group(P < 0.05).The levels of nitric oxide(NO)and vascular endothelium-dependent dilation(FMD)in the two groups were improved compared with those before treatment while endothelin-1(ET-1)and thromboxane A2(TXA2)levels were decreased compared with those before treatment.The levels of NO and FMD in the experimental group were significantly higher than those in the control group and the levels of ET-1 and TXA2 were significantly lower than those in the control group(P < 0.05). Conclusion Folic acid in the adjuvant treatment of senile hypertension has better curative effects.It can significantly reduce plasma Hcy level,improve vascular endothelial function of senile hypertension and reduce functional damage,which has certain clinical value of promotion.
Objective To study curative effects of folic acid in the adjuvant treatment of senile hypertension and its effect on Hcy and vascular endothelial function. Methods 62 elderly patients with hypertension who were admitted and treated in our hospital from March 1,2015 to March 1,2018 were selected.According to the random principle,they were randomly divided into the control group(31 cases)and the experimental group(31 cases).The control group was treated with antihypertensive drugs while the experimental group was treated with folic acid on the basis of the control group.After 6 months of treatment,curative effects of elderly patients with hypertension and its effect on Hcy and vascular endothelial function in two groups were observed. Results The total effective rate of the control group and the experimental group were 64.52% and 90.32%,respectively(P < 0.05).The levels of plasma Hcy in both groups were significantly lower than those before treatment and the experimental group was significantly lower than the control group(P < 0.05).The levels of nitric oxide(NO)and vascular endothelium-dependent dilation(FMD)in the two groups were improved compared with those before treatment while endothelin-1(ET-1)and thromboxane A2(TXA2)levels were decreased compared with those before treatment.The levels of NO and FMD in the experimental group were significantly higher than those in the control group and the levels of ET-1 and TXA2 were significantly lower than those in the control group(P < 0.05). Conclusion Folic acid in the adjuvant treatment of senile hypertension has better curative effects.It can significantly reduce plasma Hcy level,improve vascular endothelial function of senile hypertension and reduce functional damage,which has certain clinical value of promotion.
引文
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[12]赵莉,唐崑,郭冬杰,等.叶酸在高同型半胱氨酸血症中应用时机的回顾性分析[J].中国药学杂志,2015,50(10):905-908.
[13]张淑英.高血压并高同型半胱氨酸血症的治疗与动脉硬化的关系[J].中国实用神经疾病杂志,2015,18(9):29-31.
[14]彭慧,陈苏,王四坤,等.叶酸联合VitB12治疗对高血压合并高同型半胱氨酸血症患者血生化指标及颈动脉硬化的影响[J].海南医学院学报2016,22(18):2205-2208.
[15]蒋小菊.硝苯地平控释片联合依那普利叶酸片治疗高血压的疗效及对Hcy、尿酸、肌酐清除率的影响[J].中西医结合心脑血管病杂志,2018,16(10):1402-1404.
[2]李建平,卢新政,霍勇,等.H型高血压诊断与治疗专家共识[J].中华高血压杂志,2016,24(2):123-127.
[3]方锦河.硝苯地平控释片联合安体舒通治疗老年高血压的效果观察[J].中外医学研究,2017,15(14):148-150.
[4]周汉力,龙静,刘琼.氯沙坦钾、依那普利叶酸片治疗扩张型心肌病慢性心衰的疗效及对患者血清细胞因子及心肌纤维化的影响[J].内科,2018,13(4):636-638.
[5]隋利军,桑建,朝亚.叶酸、维生素B12对老年高血压患者血浆同型半胱氨酸水平及血管内皮功能的影响[J].中国生化药物杂志,2015,35(1):125-127.
[6]张立红.依那普利联合叶酸片治疗H型高血压疗效及作用机制探讨[J].海南医学院学,2016,22(2):147-150.
[7]李倩,李东霞.高血压合并高同型半胱氨酸血症的研究进展[J].心血管病血研究进展,2018,39(2):187-189.
[8]陈锋,乔晋,张力.叶酸对老年高血压病患者的临床疗效及对血浆同型半胱氨酸与血管内皮功能的影响[J].河北医学,2016,22(10):1607-1610.
[9]王冬,于旭红,沙杭.叶酸的临床应用现状[J].中国临床药理学杂志,2016,32(19):1813-1820.
[10]康明亮,王华明.血清同型半胱氨酸、叶酸、维生素B12在老年高血压及合并冠心病患者中的水平分析[J].淮海医药,2018,36(4):470-472.
[11]朱文秀,贾雪芝.H型高血压伴营养性巨幼细胞贫血患者治疗中血清同型半胱氨酸、维生素B12及叶酸联合检测的应用[J].国际检验医学杂志,2015,36(13):1949-1950.
[12]赵莉,唐崑,郭冬杰,等.叶酸在高同型半胱氨酸血症中应用时机的回顾性分析[J].中国药学杂志,2015,50(10):905-908.
[13]张淑英.高血压并高同型半胱氨酸血症的治疗与动脉硬化的关系[J].中国实用神经疾病杂志,2015,18(9):29-31.
[14]彭慧,陈苏,王四坤,等.叶酸联合VitB12治疗对高血压合并高同型半胱氨酸血症患者血生化指标及颈动脉硬化的影响[J].海南医学院学报2016,22(18):2205-2208.
[15]蒋小菊.硝苯地平控释片联合依那普利叶酸片治疗高血压的疗效及对Hcy、尿酸、肌酐清除率的影响[J].中西医结合心脑血管病杂志,2018,16(10):1402-1404.