老年高血压患者血清同型半胱氨酸水平的变化及叶酸治疗的作用

目的:探讨血清同型半胱氨酸(Hcy)水平在老年高血压患者的变化以及应用叶酸治疗的干预效果。方法:选择200例老年原发性高血压患者及100例未合并高血压的健康体检者作为研究对象。根据随机数字表法将老年高血压患者随机分为观察组(n=100)与对照组(n=100),对照组常规降压,观察组联合口服叶酸片治疗(5mg,每天1次),比较高血压患者及健康组血清Hcy水平,以及2组高血压患者治疗前后血清Hcy水平的变化及随访1年后主要心脏不良事件(MACE)发生率。结果:高血压患者血清Hcy水平及HHcy发生率均明显高于健康组,差异有显著性(P<0.05);治疗后,血清Hcy水平在观察组患者为(14.29±5.62)μmol·L^-1,与治疗前比较有显著下降,并且显著低于对照组的水平即(19.54±6.38)μmol·L^-1,差异均有显著性(P<0.05);MACE发生率在观察组患者为7%,与对照组的16%相比明显为低,差异有显著性(P<0.05)。结论:老年高血压患者应用叶酸治疗可能通过降低血清Hcy水平进一步降低患者MACE发生的风险,对患者预后的改善有利。

Changes of serum homocysteine in elderly patients with hypertension and the effect of folic acid treatment

OBJECTIVE To investigate the changes of serum homocysteine (Hcy) levels in elderly patients with hypertension and the effect of folic acid. METHODS Totally 200 cases of elderly primary hypertension patients and 100 healthy persons without hypertension were enrolled. The hypertensive patients were randomly divided into observation group (n=100) and control group (n=100) according to the random number table method. Patients in control group were treated by conventional antihypertensive drugs, patients in the observation group were combined with folic acid (5 mg qd). Levels of serum Hcy were compared between hypertensive and healthy patients, before and after treatment. Hcy was also compared between two hypertensive groups. After 1 year, the major adverse cardiac events (MACE) rates were compared. RESULTS The serum Hcy levels and Hcy rates in hypertension group were significantly higher than those in the healthy group (P<0.05). After treatment, the serum Hcy level in the observation group was (14.29±5.62) μmol·L^-1, which was significantly decreased, lower than that in the control group (19.54±6.38) μmol·L^-1 (P<0.05). The MACE rate in the observation group was 7%, significantly lower than that in the control group (16%) (P<0.05). CONCLUSION The treatment of folic acid in elderly patients with hypertension may reduce the serum Hcy and lower risk of MACE, and improve the prognosis.