广州医科大学学报

目的:观察叶酸辅助治疗对伴高同型半胱氨酸(Hcy)血症高血压患者颈动脉硬化的影响。方法:选取我院2018年1月至2019年5月收治的80例伴高Hcy血症高血压患者,完全随机分4组,每组各20例。对照组给予常规基础治疗,高剂量组、中剂量组、低剂量组分别在常规基础治疗同时给予相应剂量叶酸辅助治疗,比较4组治疗前后血压、血浆Hcy、一氧化氮(NO)水平及颈动脉硬化程度[内中膜厚度(IMT)与斑块Crouse积分]。"结果:治疗后,高剂量组收缩压、舒张压、Hcy水平、颈动脉IMT、斑块Crouse积分明显低于中剂量组、低剂量组、对照组(P<0.05),中剂量组、低剂量组明显低于对照组(P<005);高剂量组NO水平明显高于中剂量组、低剂量组、对照组(P<0.05),中剂量组、低剂量组明显高于对照组(P<0.05)。结论:叶酸辅助疗法,尤其选择高剂量叶酸,可有效降低伴高Hcy血症高血压患者血压、Hcy水平,提高NO水平,改善颈动脉硬化情况。

Objective:To investigate the effect of adjuvant therapy with folic acid on carotid arteriosclerosis in hypertensive patients with with hyperhomocysteinemia.Methods:A total of 80 hypertensive patients with hyperhomocysteinemia treated in our hospital between January 2018 and May 2019 were randomly divided into 4 groups(n= 20 each). The control group was given conventional care,and in addition to this,the high-dose,medium-dose and low-dose folic acid groups were given adjuvant therapy with corresponding dose of folic acid.The blood pressure,plasma hyperhomocysteine(Hcy)and nitric oxide(NO)levels,and carotid arteriosclerosis[intima-media thickness(IMT)and Crouse's plaque score]were compared between the 4 groups before and after treatment.Results:After treatment,the systolic and diastolic blood pressures,Hcy level,carotid IMT,and Crouse's plaque score were significantly lower in the high-dose group than those in the medium-dose group,lowdose group,and control group(P<0.05),and were significantly lower in the medium-dose and low-dose groups than those in the control group(P<0.05). The NO level was significantly higher in the high-dose group than that in the medium-dose group,the low-dose group,and the control group(P<0.05),and was significantly higher in the medium-dose and low-dose groups than that in the control group(P<0.05).Conclusion:Adjuvant therapy with folic therapy,particulary at high doses,can effectively reduce blood pressure and Hcy levels,increase NO levels,and improve carotid arteriosclerosis in hypertensive patients with hyperhomocysteinemia.