原发性高血压患者补充适量的叶酸、维生素B12对其治疗效果影响的临床研究

目的探讨原发性高血压患者给予叶酸及维生素B12治疗前后血浆同型半胱氨酸（Hcy）、不对称二甲基精氨酸（ADMA），血清一氧化氮（NO）及内皮性一氧化氮合酶（eNOS）水平的变化。方法选取156例原发性高血压患者为研究对象，按随机数字表法分成两组，每组78例。对照组给予常规降压治疗，试验组在对照组治疗的基础上给予口服叶酸及维生素B12，比较两组治疗前后Hcy、ADMA、NO及eNOS水平的变化。结果对照组治疗后2、12周Hcy及ADMA水平与治疗前比较差异无统计学意义（P〉0．05）；试验组治疗后2、12周Hcy、ADMA水平较治疗前显著降低，差异有统计学意义（P〈0．05）。治疗后12周，试验组NO、eNOS水平高于对照组（77．35±9．55）拉mol／L比（64．26±11．49）μmol／L、（30．05±6．88）μmol／L比（19．92±10．24）μmol/L]，差异有统计学意义（P〈0．05）。原发性高血压患者ADMA水平与Hcy水平呈正相关（r=0．612，P〈0.05），与NO和eNOS水平呈负相关（r=-0．557、-O．529，P〈0．05）。结论原发性高血压患者适当补充叶酸及维生素B12可降低血液中Hcv和ADMA的水平，升高NO、eNOS水平，改善患者血管内皮细胞功能，并可辅助降低血压，有利于预防心脑血管意外的发生。

Impact of adding folic acid and vitamin Bu combined with standard antihyperteusive medication on therapeutic effects

Objective To investigate the impact of adding folic acid and vitamin B12 combined with standard antihypertensive medication on plasma homocysteine （Hcy） and asymmetric dimethylarginine （ADMA）,serum NO and endothelial nitric oxide synthase （eNOS） of essential hypertensive patients. Methods One hundred and fifty-six patients with essential hypertension were divided into control group and experimental group with 78 cases by random digits table method. Control group received conventional antihypertensive therapy,while experimental group were treated with folic acid and vitamin B12 based on the treatment of control group. Plasma Hcy and ADMA, serum NO and eNOS levels were observed at baseline 2 and 12 weeks after treatment. Results In control group, the level of Hey and ADMA showed no significant difference before and 2,12 weeks after treatment （P 〉 0.05 ） .The level of Hcy and ADMA before treatment was significantly higher than that 2 , 12 weeks after treatment in experimental group （P 〈 0.05 ）. The level of NO and eNOS 12 weeks after treatment in experimental group was significantly higher than that in control group （77.35 ± 9.55 ） μmol/L vs. （ 64.26 ±11.49） μmol/L, （ 30.05± 6.88 ） μ mol/L vs. （ 19.92 ±10.24） μ mol/L, P 〈 0.05 ]. The level of ADMA was positively correlated with Hcy at baseline （ r = 0.612, P 〈 0.05 ）, and was negatively correlated with NO and eNOS （r =-0.557,-0.529,P 〈0.05）. Conclusions Supplementation of folic acid and vitamin B12 helps to improve endothelial function and reduce plasma Hcy and ADMA levels as well as improve serum NO and eNOS levels in patients with essential hypertension, which helps to prevent from cardiovascular and cerebrovascular accidents.